Organization Active NPI

Primary Care in the Home, Inc

  • Family Nurse Practitioner
  • Kissimmee, FL
National Provider Identifier
1568177632
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
PRIMARY CARE IN THE HOME, INC
Practice address
3098 Eagle Crossing Dr
Kissimmee, FL 34746-3160
Phone
(407) 201-2680
Fax
(407) 201-2680
NPI assigned
Jan 23, 2023
Last updated
Jan 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Authorized official

Name
Robert Anthony Otero, APRNNPI 1033400122
Title
Ceo
Phone
(954) 548-8735

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

3098 Eagle Crossing Dr
Kissimmee, FL 34746-3160

Mailing address

3098 Eagle Crossing Dr
Kissimmee, FL 34746-3160
Phone (407) 201-2680

Other identifiers 1

IdentifierTypeStateIssuer
016105300MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1568177632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3098 EAGLE CROSSING DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463160",
            "telephone_number": "407-201-2680",
            "fax_number": "407-201-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3098 EAGLE CROSSING DR",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347463160",
            "telephone_number": "407-201-2680",
            "fax_number": "407-201-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE IN THE HOME, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "OTERO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "954-548-8735",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016105300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kissimmee, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.