NPIMap

Organization Active NPI

Mayflower Home Health Agency, LLC

  • Home Health Agency
  • Winter Park, FL
National Provider Identifier
1790083244
Registry record updated Jun 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
MAYFLOWER HOME HEALTH AGENCY, LLC
Practice address
1620 Mayflower CT
Winter Park, FL 32792-2500
Phone
(407) 672-1620
NPI assigned
Mar 8, 2011
Last updated
Jun 2, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2014

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

Authorized official

Name
Mr. Kenneth H. Schultz
Title
Ceo - Management Company
Phone
(407) 645-3211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X NU Primary

Addresses

Primary practice location

1620 Mayflower CT
Winter Park, FL 32792-2500

Mailing address

1890 State Road 436
Suite 300
Winter Park, FL 32792-2285
Phone (407) 645-3211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120529000150 FL Part A Provider - Home Health Agency 5496918609 Practice locations: Winter Park, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1790083244. Details of each certification follow.

Home health agency certification: CCN 103169

Legal name
MAYFLOWER HOME HEALTH AGENCY, LLC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Jan 3, 2013
Last certification
Sep 9, 2021
Ownership / control type
Non-Profit
Organization structure
LLCProprietary
Incorporated
Feb 23, 2011 in FL
Enrollment address
1620 Mayflower CT
Winter Park, FL 32792-2500

Care Compare: Home health agency

Medicare Care Compare
Listed as
Mayflower Home Health Agency LLCCCN 103169 · All quality measures
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Jan 3, 2013
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Physical therapy, Speech pathology, Occupational therapy

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2030557Mayflower Home Health Agency, LLC1620 Mayflower Court, Winter Park, FL 32792Certificate of waiverSep 28, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Gregory Schultz Individual Operational/Managerial Control Feb 23, 2011 100%
Steven a Kramer Individual Corporate Officer Aug 24, 2015
Mayflower Retirement Center, Inc. Dba Mayflower Healthcare Center Organization, Winter Park, FL Corporation 5% Or Greater Direct Ownership Interest Jun 21, 2011 96%
Operational/Managerial Control Jun 21, 2011
Dsi Management LLC Organization, Winter Park, FL Management services company Operational/Managerial Control Jun 21, 2011 100%
Kenneth Schultz Individual Operational/Managerial Control Feb 23, 2011 100%

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1299542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401667200000",
    "number": "1790083244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 STATE ROAD 436",
            "address_2": "SUITE 300",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327922285",
            "telephone_number": "407-645-3211",
            "fax_number": "407-628-2853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 MAYFLOWER CT",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327922500",
            "telephone_number": "407-672-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYFLOWER HOME HEALTH AGENCY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-08",
        "last_updated": "2014-06-02",
        "status": "A",
        "authorized_official_last_name": "SCHULTZ",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CEO - MANAGEMENT COMPANY",
        "authorized_official_telephone_number": "407-645-3211",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.