Community Care of Tampa,Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

299993260 Issued in FL

Legal business name

COMMUNITY CARE OF TAMPA,INC

Practice address

3104 W Waters Ave
Suite 101
Tampa, FL 33614-2800

Phone

(813) 425-5573

Fax

(813) 425-2765

NPI assigned

Oct 3, 2008

Last updated

Sep 22, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Anaicel Gonzalez

Title

President

Phone

(813) 425-5573

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1710138193. Details of each certification follow.

• CCN 109740 Home health agency · Active · Details

Home health agency certification: CCN 109740

Legal name

COMMUNITY CARE OF TAMPA,INC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 12, 2011

Last certification

Sep 5, 2014

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Oct 5, 2006 in FL

Enrollment address

3104 W Waters Ave
Ste 200
Tampa, FL 33614-2877

Listed as

Community Care of Tampa IncCCN 109740 · All quality measures

Ownership

Proprietary

Certified

Dec 12, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474502400000",
    "number": "1710138193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 W WATERS AVE",
            "address_2": "SUITE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142800",
            "telephone_number": "813-425-5573",
            "fax_number": "813-425-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 W WATERS AVE",
            "address_2": "SUITE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336142800",
            "telephone_number": "813-425-5573",
            "fax_number": "813-425-2765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CARE OF TAMPA,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-03",
        "last_updated": "2016-09-22",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "ANAICEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-425-5573",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299993260",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Tampa, FL
• Providers in Tampa, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.

Verify at the official NPI Registry.