Provident Home Care, Inc.

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

PROVIDENT HOME CARE, INC.

Practice address

4934 17TH Ave N
St Petersburg, FL 33710-5202

Phone

(615) 347-0900

NPI assigned

Jan 10, 2019

Organization subpart

No

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

Authorized official

Name

David E Wilson, CPA

Title

Owner/Cfo

Phone

(615) 347-0900

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547078400000",
    "number": "1831662022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 PEBBLE CREEK RD",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370645525",
            "telephone_number": "615-347-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4934 17TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337105202",
            "telephone_number": "615-347-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENT HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-10",
        "last_updated": "2019-01-10",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/CFO",
        "authorized_official_telephone_number": "615-347-0900",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in St Petersburg, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.