Eternity Homecare, Inc.

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

ETERNITY HOMECARE, INC.

Practice address

1402 Greenway Cross
Suite 101
Madison, WI 53713-3181

Phone

(608) 251-2273

Fax

(866) 748-3232

NPI assigned

Sep 21, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kelly Kline Burnett, MBA

Title

Business Liaison

Phone

(608) 251-2273

Specialties & licenses 12

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vang Thao, ADMINISTRATOR

  • Home Health Aide
  • Madison, WI
  • NPI 1770996100
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442793600000",
    "number": "1528437498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 GREENWAY CROSS",
            "address_2": "SUITE 101",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537133181",
            "telephone_number": "608-251-2273",
            "fax_number": "866-748-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 GREENWAY CROSS",
            "address_2": "SUITE 101",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537133181",
            "telephone_number": "608-251-2273",
            "fax_number": "866-748-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETERNITY HOMECARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-21",
        "last_updated": "2015-09-21",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "KLINE",
        "authorized_official_title_or_position": "BUSINESS LIAISON",
        "authorized_official_telephone_number": "608-251-2273",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "WI",
            "license": "100014484",
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WI",
            "license": "100014484",
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251F00000X",
            "taxonomy_group": "",
            "desc": "Home Infusion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251T00000X",
            "taxonomy_group": "",
            "desc": "Program of All-Inclusive Care for the Elderly (PACE) Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "WI",
            "license": "100014484",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1770996100",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100014484",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul Michael Estrada, M.D.
• Alicia Estrella, DMD
• Christopher Michael Estrella, MS
• Flaviano Estrella, LVN
• Sarah O Estrella, LSCW
• Ethicare Transportation LLC
• Brian Lee Ethridge, PTA
• Clarisse P Ethridge, MD
• Hannah M Ethun
• Abigail Eubanks

• Nursing Care Agency in Madison, WI
• Providers in Madison, WI by specialty
• Nursing Care Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.