NPIMap

Organization Active NPI

Modivcare Solutions, LLC

  • Transportation Broker
  • Miami Lakes, FL
National Provider Identifier
1619364270
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transportation BrokerTaxonomy code 347E00000X
Legal business name
MODIVCARE SOLUTIONS, LLC
Practice address
5875 NW 163Rd St Ste 203
Miami Lakes, FL 33014-5618
Phone
(800) 698-8457
Fax
(305) 471-0443
NPI assigned
Apr 22, 2015
Last updated
Jan 27, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MODIVCARE INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Authorized official

Name
Daniel Greenleaf
Title
President & Chief Executive Officer
Phone
(800) 486-7647

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Transportation Broker 347E00000X Primary

Addresses

Primary practice location

5875 NW 163Rd St Ste 203
Miami Lakes, FL 33014-5618

Mailing address

1275 Peachtree St NE
6TH Floor
Atlanta, GA 30309-3580
Phone (800) 486-7647

Other identifiers 5

IdentifierTypeStateIssuer
014158202MedicaidFL
014158200MedicaidFL
014158204MedicaidFL
014158203MedicaidFL
014158201MedicaidFL

Other names 1

  • LGTC FL AHCA Other name

National Provider Directory

National Provider Directory
Tax ID family
Theresa a Wright15 organizations share this tax ID, including this one
Part of
Providence Human Services of Wa

Other organizations with this tax ID 14

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

View all 14

Locations

8600 NW 36th St
Ste 600
Doral, FL 33166

5875 NW 163rd St
Ste 203
Miami Lakes, FL 33014
Phone (800) 698-8457

NPI Registry JSON

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1619364270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 PEACHTREE ST NE",
            "address_2": "6TH FLOOR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093580",
            "telephone_number": "800-486-7647",
            "fax_number": "404-888-5999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5875 NW 163RD ST STE 203",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330145618",
            "telephone_number": "800-698-8457",
            "fax_number": "305-471-0443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODIVCARE SOLUTIONS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MODIVCARE INC.",
        "enumeration_date": "2015-04-22",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "GREENLEAF",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "800-486-7647"
    },
    "taxonomies": [
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014158202",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014158200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014158204",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014158203",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "014158201",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LGTC FL AHCA",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "LGTC FL AHCA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Miami Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.