Active NPI
Homecare Advantage, Inc.
- Home Health Agency
- Green Bay, WI
National Provider Identifier
1710011010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- Legal business name
- HOMECARE ADVANTAGE, INC.
- Practice address
- 1496 Bellevue St
Suite 501
Green Bay, WI 54311-4205 - Phone
- (920) 437-0496
- Fax
- (920) 437-8206
- NPI assigned
- Mar 16, 2007
- 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
- Ann M Anderson, RN
- Title
- Administrator
- Phone
- (920) 437-0496
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | WI | Primary |
Addresses
Primary practice location
1496 Bellevue St
Suite 501
Green Bay, WI 54311-4205
Mailing address
1496 Bellevue St
Suite 501
Green Bay, WI 54311-4205
Phone (920) 437-0496
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 41509700 | Medicaid | WI |
National Provider Directory
National Provider DirectoryLocations
1496 Bellevue St
Ste 501
Green Bay, WI 54311
Phone (920) 406-8861
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1304467200000",
"number": "1710011010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1496 BELLEVUE ST",
"address_2": "SUITE 501",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543114205",
"telephone_number": "920-437-0496",
"fax_number": "920-437-8206"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1496 BELLEVUE ST",
"address_2": "SUITE 501",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543114205",
"telephone_number": "920-437-0496",
"fax_number": "920-437-8206"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HOMECARE ADVANTAGE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-16",
"last_updated": "2011-05-04",
"status": "A",
"authorized_official_last_name": "ANDERSON",
"authorized_official_first_name": "ANN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "920-437-0496",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "WI",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "41509700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.