Organization Active NPI

Peak Provider Services, Inc

  • In Home Supportive Care Agency
  • Holiday, FL
National Provider Identifier
1578865028
Registry record updated Jan 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
PEAK PROVIDER SERVICES, INC
Practice address
2435 US Highway 19
Suite 540
Holiday, FL 34691-3903
Phone
(727) 505-0459
Fax
(727) 940-3492
NPI assigned
Dec 2, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2014

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

Authorized official

Name
Jeffrey Scott Kocina
Title
President/Owner
Phone
(727) 505-0459

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

2435 US Highway 19
Suite 540
Holiday, FL 34691-3903

Mailing address

PO Box 3970
Holiday, FL 34692-0970
Phone (727) 505-0459

Other identifiers 2

IdentifierTypeStateIssuer
686781201MedicaidFL
686781296MedicaidFL

National Provider Directory

National Provider Directory

Locations

2435 US Highway 19
Ste 540
Holiday, FL 34691
Phone (727) 505-0459

NPI Registry JSON

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390262400000",
    "number": "1578865028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3970",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "346920970",
            "telephone_number": "727-505-0459",
            "fax_number": "727-857-3381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 US HIGHWAY 19",
            "address_2": "SUITE 540",
            "city": "HOLIDAY",
            "state": "FL",
            "postal_code": "346913903",
            "telephone_number": "727-505-0459",
            "fax_number": "727-940-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PROVIDER SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2014-01-21",
        "status": "A",
        "authorized_official_last_name": "KOCINA",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "727-505-0459"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "686781201",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "686781296",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holiday, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2014; 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.