Active NPI
T. C. Fitzgerald Inc.
- In Home Supportive Care Agency
- Henderson, NV
National Provider Identifier
1679139398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Legal business name
- T. C. FITZGERALD INC.
- Practice address
- 335 W Sherwood Dr
Henderson, NV 89015-7700 - Phone
- (702) 396-6906
- NPI assigned
- May 17, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Thomas Allan Fitzgerald III
- Title
- Administrator
- Phone
- (702) 496-6906
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
335 W Sherwood Dr
Henderson, NV 89015-7700
Mailing address
335 W Sherwood Dr
Henderson, NV 89015-7700
Phone (702) 396-6906
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9005053861 | Medicaid | NV |
Other names 1
- Diamond Retirement Living
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 29D2254304 | Diamond Retirement Living | Certificate of waiver | Mar 1, 2028 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558051200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1558051200000",
"number": "1679139398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "335 W SHERWOOD DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890157700",
"telephone_number": "702-396-6906"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 W SHERWOOD DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890157700",
"telephone_number": "702-396-6906"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "T. C. FITZGERALD INC.",
"organizational_subpart": "NO",
"enumeration_date": "2019-05-17",
"last_updated": "2019-05-17",
"status": "A",
"authorized_official_last_name": "FITZGERALD",
"authorized_official_first_name": "THOMAS",
"authorized_official_middle_name": "ALLAN",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "702-496-6906",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "III"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9005053861",
"state": "NV"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Diamond Retirement Living",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.