Individual provider Active NPI

Deneze M Douglas

  • Nursing Care Agency
  • Miramar, FL
National Provider Identifier
1558855874
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
License
30212360 Issued in FL
Practice address
7957 Orleans St
Miramar, FL 33023-3561
Phone
(786) 985-0690
Fax
(754) 888-9175
NPI assigned
Jun 20, 2018
Last updated
May 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 24912 FL
Nursing Care Agency 251J00000X 30212360 FL Primary
Health Maintenance Organization 302R00000X FL
Adult Companion 372600000X 24912 FL
Home Health Aide 374U00000X RAHC113392 FL
Homemaker 376J00000X 235358 FL
In Home Supportive Care Agency 253Z00000X 28230 FL

Addresses

Primary practice location

7957 Orleans St
Miramar, FL 33023-3561

Mailing address

7957 Orleans St
Miramar, FL 33023-3561
Phone (786) 985-0690

Other identifiers 4

IdentifierTypeStateIssuer
025122500MedicaidFL
101222400MedicaidFL
101375000MedicaidFL
111194600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
24912FLMDHome Health Agency
30212360FLMDNursing Care Agency
28230FLMDIn Home Supportive Care Agency
RAHC113392FLMDHome Health Aide
235358FLMDHomemaker

Practice roles

OrganizationSpecialtyStatusNew patients
Wings of an Angel Inc Multi-Specialty Current Accepting new patients
Wings of an Angel Inc Multi-Specialty CurrentSince Feb 21, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1558855874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7957 ORLEANS ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330233561",
            "telephone_number": "786-985-0690",
            "fax_number": "754-888-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7957 ORLEANS ST",
            "city": "MIRAMAR",
            "state": "FL",
            "postal_code": "330233561",
            "telephone_number": "786-985-0690",
            "fax_number": "754-888-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "DENEZE",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "24912",
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "FL",
            "license": "30212360",
            "primary": true
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "FL",
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": "FL",
            "license": "24912",
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "FL",
            "license": "RAHC113392",
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "FL",
            "license": "235358",
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "FL",
            "license": "28230",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025122500",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101222400",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101375000",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111194600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miramar, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2022; 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.