Individual provider Active NPI

Kelly P.K. Royer Thybulle

  • In Home Supportive Care Agency
  • North Lauderdale, FL
National Provider Identifier
1811567837
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Practice address
8020 Hampton Blvd Apt 511
North Lauderdale, FL 33068-5647
Phone
(786) 458-3380
NPI assigned
Jun 30, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

8020 Hampton Blvd Apt 511
North Lauderdale, FL 33068-5647

Mailing address

8020 Hampton Blvd Apt 511
North Lauderdale, FL 33068-5647
Phone (786) 458-3380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1811567837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8020 HAMPTON BLVD APT 511",
            "city": "NORTH LAUDERDALE",
            "state": "FL",
            "postal_code": "330685647",
            "telephone_number": "786-458-3380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8020 HAMPTON BLVD APT 511",
            "city": "NORTH LAUDERDALE",
            "state": "FL",
            "postal_code": "330685647",
            "telephone_number": "786-458-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYER THYBULLE",
        "first_name": "KELLY",
        "middle_name": "P.K.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.