NPIMap

Organization Active NPI

Serenity Supplies

  • Durable Medical Equipment & Medical Supplies
  • Riviera Beach, FL
National Provider Identifier
1871132480
Registry record updated Dec 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SERENITY SUPPLIES
Practice address
1420 W 26TH CT
Riviera Beach, FL 33404-4123
Phone
(561) 601-7773
NPI assigned
Dec 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2019

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

Authorized official

Name
Simone Jackson, MANPI 1437519394
Title
Co-Owner
Phone
(561) 601-7773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary
Home Delivered Meals 332U00000X

Addresses

Primary practice location

1420 W 26TH CT
Riviera Beach, FL 33404-4123

Mailing address

1420 W 26TH CT
Riviera Beach, FL 33404-4123
Phone (561) 601-7773

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577664000000",
    "number": "1871132480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 W 26TH CT",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334044123",
            "telephone_number": "561-601-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 W 26TH CT",
            "city": "RIVIERA BEACH",
            "state": "FL",
            "postal_code": "334044123",
            "telephone_number": "561-601-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY SUPPLIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-30",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "SIMONE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "561-601-7773",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332U00000X",
            "taxonomy_group": "",
            "desc": "Home Delivered Meals",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riviera Beach, FL

Sources for this page

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