Individual provider Active NPI

Cindy Donna Watkins

  • Homemaker
  • Lauderhill, FL
National Provider Identifier
1831385525
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
HomemakerTaxonomy code 376J00000X
Practice address
3800 Inverrary Blvd Ste 100P
Lauderhill, FL 33319-4316
Phone
(954) 895-0295
Fax
(954) 533-1425
NPI assigned
Sep 17, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X 688093296 FL
Developmentally Disabled Services Day Training Agency 251C00000X
HomemakerGroup: 193200000X MULTI-SPECIALTY GROUP 376J00000X Primary

Addresses

Primary practice location

3800 Inverrary Blvd Ste 100P
Lauderhill, FL 33319-4316

Mailing address

200 Pennsylvania Ave
Ft. Lauderdale, FL 33312-1833
Phone (954) 895-0295

Other practice location 1

200 Pennsylvania Ave
Ft Lauderdale, FL 33312-1833
Phone (954) 895-0295

Other identifiers 2

IdentifierTypeStateIssuer
688093296MedicaidFL
688093298MedicaidFL

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

State licenses

LicenseStateTypeSpecialty
688093296FLMDCase Manager/Care Coordinator

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom of Choice Support Services, Inc. Day Training, Developmentally Disabled Services CurrentSince Jul 24, 2022 Accepting new patients
Freedom of Choice Support Services So FL, Inc. CurrentSince Apr 9, 2024 Accepting new patients

Locations

3800 Inverrary Blvd
Ste 100P
Lauderhill, FL 33319
Phone (954) 895-0295

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1831385525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PENNSYLVANIA AVE",
            "city": "FT. LAUDERDALE",
            "state": "FL",
            "postal_code": "333121833",
            "telephone_number": "954-895-0295",
            "fax_number": "954-533-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 INVERRARY BLVD STE 100P",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333194316",
            "telephone_number": "954-895-0295",
            "fax_number": "954-533-1425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Ft Lauderdale",
            "state": "FL",
            "postal_code": "333121833",
            "country_code": "US",
            "telephone_number": "954-895-0295",
            "fax_number": "954-316-6579",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATKINS",
        "first_name": "CINDY",
        "middle_name": "DONNA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "FL",
            "license": "688093296",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "688093296",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "688093298",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderhill, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.