Active NPI
Family Home Care Group, LLC
- Home Health Agency
- Orlando, FL
National Provider Identifier
1811254899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 299993988
- Legal business name
- FAMILY HOME CARE GROUP, LLC
- Practice address
- 622 E Washington St Ste 200
Orlando, FL 32801-2966 - Phone
- (407) 401-9146
- Fax
- (407) 517-4860
- NPI assigned
- Apr 16, 2012
- 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
- Lea F Ball, RN
- Title
- Owner/Administrator
- Phone
- (407) 401-9146
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 299993988 | FL | Primary |
Addresses
Primary practice location
622 E Washington St Ste 200
Orlando, FL 32801-2966
Mailing address
622 E Washington St Ste 200
Orlando, FL 32801-2966
Phone (407) 401-9146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 299993988 | Other | FL | AGENCY FOR HEALTH CARE ADMINISTRATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120619000051 | FL | Part A Provider - Home Health Agency | 7517121825 | Practice locations: Orlando, FL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1811254899. Details of each certification follow.
Home health agency certification: CCN 103144
- Legal name
- FAMILY HOME CARE GROUP, LLC
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Nov 6, 2012
- Last certification
- May 24, 2017
- Ownership / control type
- Proprietary
- Organization structure
- LLC
- Enrollment address
- 622 E Washington St
Ste 200
Orlando, FL 32801-2966
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Family Home Care Group LLC
- Overall star rating
- Ownership
- Proprietary
- Certified
- Nov 6, 2012
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider DirectoryLocations
5401 S Kirkman Rd
#223
Orlando, FL 32819
622 E Washington St
Ste 200
Orlando, FL 32801
Phone (407) 401-9146
5401 S Kirkman Rd
Ste 510
Orlando, FL 32819
Phone (407) 401-9146
5401 S Kirkman Rd
Ste 223
Orlando, FL 32819
Phone (407) 401-9146
Networks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Ownership & related parties
All disclosed owners & managing parties 2
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Nicholas Pooler | 5% Or Greater Direct Ownership Interest | Apr 3, 2023 | 40% |
| Operational/Managerial Control | Apr 3, 2023 | 40% | |
| Kimberly James | 5% Or Greater Direct Ownership Interest | Apr 3, 2023 | 60% |
| Operational/Managerial Control | Apr 3, 2023 | 60% |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Physical Therapist
- Altamonte Springs, FL
- NPI 1780080671
Affiliated clinicians 32
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- Orlando, FL
- NPI 1952311870
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334534400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1731542400000",
"number": "1811254899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "622 E WASHINGTON ST STE 200",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328012966",
"telephone_number": "407-401-9146",
"fax_number": "407-517-4860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 E WASHINGTON ST STE 200",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328012966",
"telephone_number": "407-401-9146",
"fax_number": "407-517-4860"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY HOME CARE GROUP, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-04-16",
"last_updated": "2024-11-14",
"certification_date": "2024-11-14",
"status": "A",
"authorized_official_last_name": "BALL",
"authorized_official_first_name": "LEA",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
"authorized_official_telephone_number": "407-401-9146",
"authorized_official_credential": "RN"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "FL",
"license": "299993988",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AGENCY FOR HEALTH CARE ADMINISTRATION",
"identifier": "299993988",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Orlando, FL
- Family Eye Care, LLC
- Family First Behavior Inc.
- Family First Care LLC
- Family First Homecare, LLC (Family First Homecare of Orlando)
- Family Health Primary Care Providers, LLC
- Family Integrative Medicine , LLC
- Family Integrative Medicine of Orlando
- Family Internal Medicine, PA
- Family Life Counseling Center
- Family Medical Clinic, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.