Organization Active NPI

Homecare Advantage, Inc.

  • Home Health Agency
  • Green Bay, WI
National Provider Identifier
1710011010
Registry record updated May 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
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

Updated by the provider on May 4, 2011

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
41509700MedicaidWI

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.