Southerly Home Health LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

SOUTHERLY HOME HEALTH LLC

Practice address

1279 Kingsley Ave Ste 114
Orange Park, FL 32073-4604

Phone

(904) 999-9243

NPI assigned

Feb 3, 2023

Last updated

Feb 3, 2023By 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

Kenneth Holifield

Title

Owner/Ceo

Phone

(904) 999-9243

Specialties & licenses 1

Addresses

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.

• Glorive Holifield, L.C.S.W.

  • Clinical Social Worker
  • Orange Park, FL
  • NPI 1700164316
  NPD (past)

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

{
    "created_epoch": "1675382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675382400000",
    "number": "1821794561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1279 KINGSLEY AVE STE 114",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734604",
            "telephone_number": "904-999-9243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 KINGSLEY AVE STE 114",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734604",
            "telephone_number": "904-999-9243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERLY HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-03",
        "last_updated": "2023-02-03",
        "certification_date": "2023-02-03",
        "status": "A",
        "authorized_official_last_name": "HOLIFIELD",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "904-999-9243"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2023; 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.