Organization Active NPI

Esp Case Management Professional, Inc

  • Community/Behavioral Health Agency
  • South Daytona, FL
National Provider Identifier
1609083476
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
ESP CASE MANAGEMENT PROFESSIONAL, INC
Practice address
687 Beville Rd Ste a
South Daytona, FL 32119-1970
Phone
(386) 760-7533
Fax
(386) 761-5868
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Authorized official

Name
Mrs. Mary L Fagaragan
Title
President
Phone
(386) 760-7533

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

687 Beville Rd Ste a
South Daytona, FL 32119-1970

Mailing address

687 Beville Rd Ste a
South Daytona, FL 32119-1970
Phone (386) 760-7533

Other identifiers 2

IdentifierTypeStateIssuer
109936300MedicaidFL
110146900MedicaidFL

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address maryf@espcasemanagement.com Direct
Direct Messaging Address maryf@espcasemanagement.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Esp Case Management Professional Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2090 S Nova Rd
Ste AA13
South Daytona, FL 32119

687 Beville Rd
Ste A
South Daytona, FL 32119
Phone (386) 760-7533

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1609083476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "687 BEVILLE RD STE A",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191970",
            "telephone_number": "386-760-7533",
            "fax_number": "386-761-5868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 BEVILLE RD STE A",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321191970",
            "telephone_number": "386-760-7533",
            "fax_number": "386-761-5868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESP CASE MANAGEMENT PROFESSIONAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "FAGARAGAN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-760-7533",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109936300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110146900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "maryf@espcasemanagement.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "maryf@espcasemanagement.com",
            "address_1": "687 Beville Rd Ste A",
            "city": "South Daytona",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321191970",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "maryf@espcasemanagement.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "687 Beville Rd Ste A",
            "city": "South Daytona",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321191970",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in South Daytona, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.