Active NPI
Deneze M Douglas
- Nursing Care Agency
- Miramar, FL
National Provider Identifier
1558855874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Care Agency
- License
- 30212360
- 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, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 025122500 | Medicaid | FL | |
| 101222400 | Medicaid | FL | |
| 101375000 | Medicaid | FL | |
| 111194600 | Medicaid | FL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 24912 | FL | MD | Home Health Agency |
| 30212360 | FL | MD | Nursing Care Agency |
| 28230 | FL | MD | In Home Supportive Care Agency |
| RAHC113392 | FL | MD | Home Health Aide |
| 235358 | FL | MD | Homemaker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wings of an Angel Inc | Multi-Specialty | Current | Accepting new patients |
| Wings of an Angel Inc | Multi-Specialty | Current | 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.