Active NPI
Etairos Care at Home Inc
- Home Health Agency
- Port St Lucie, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- HHA299992690
- Legal business name
- ETAIROS CARE AT HOME INC
- Doing business as
- Comprehensive Home Care of Palm Beach
- Practice address
- 1850 SW Fountainview Blvd
Port St Lucie, FL 34986-3443 - Phone
- (561) 588-0996
- NPI assigned
- Oct 18, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Brett Rager
- Title
- VP Reimbursement
- Phone
- (727) 614-8300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | HHA299992690 | FL | Primary |
Addresses
Primary practice location
1850 SW Fountainview Blvd
Port St Lucie, FL 34986-3443
Mailing address
13787 Belcher Rd S Ste 220
Largo, FL 33771-4065
Phone (727) 614-8300
Other names 1
- Comprehensive Home Care of Palm Beach
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Tax ID family
- Comprehensive Home Care of Palm Beach
Other organizations with this tax ID 4
Organizations that report the same tax identification number in the National Provider Directory.
-
- Home Health Agency
- Spring Hill, FL
- NPI 1033157573
-
- Home Health Agency
- West Palm Beach, FL
- NPI 1043257199
-
- Home Health Agency
- Tamarac, FL
- NPI 1598702466
-
- Home Health Agency
- Vero Beach, FL
- NPI 1700227329
Locations
6450 NW 5th Way
Ft Lauderdale, FL 33309
Phone (954) 834-2222
13787 Belcher Rd S
Ste 220
Largo, FL 33771
Phone (727) 524-2896
1850 SW Fountainview Blvd
Ste 211
Port St Lucie, FL 34986
Phone (772) 323-2133
110 Century Blvd
Ste 102
West Palm Beach, FL 33417
Phone (561) 588-0996
560 Village Blvd
Ste 335
West Palm Beach, FL 33409
Phone (561) 588-0996
2000 Palm Beach Lakes Blvd
Ste 602
West Palm Beach, FL 33409
Phone (561) 588-0996
Ownership & related parties
All disclosed owners & managing parties 7
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Polaris Management LLC | Operational/Managerial Control | Jul 14, 2010 | |
| Denise Bellville | Contracted Managing Employee | Dec 15, 2011 | |
| Garrett Bragg | 5% Or Greater Direct Ownership Interest | Feb 21, 2003 | 100% |
| Corporate Officer | Feb 21, 2003 | ||
| Corporate Director | Feb 21, 2003 | ||
| Ted Anderer | W-2 Managing Employee | Dec 4, 2017 | |
| Jamie a Plastina | Contracted Managing Employee | Aug 10, 2012 | |
| Lisa Martinolich | W-2 Managing Employee | Aug 17, 2017 | |
| Virgo Investment Group LLC | 5% Or Greater Security Interest | Jul 14, 2010 | 100% |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192665600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1632700800000",
"number": "1871782508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13787 BELCHER RD S STE 220",
"city": "LARGO",
"state": "FL",
"postal_code": "337714065",
"telephone_number": "727-614-8300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1850 SW FOUNTAINVIEW BLVD",
"city": "PORT ST LUCIE",
"state": "FL",
"postal_code": "349863443",
"telephone_number": "561-588-0996"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ETAIROS CARE AT HOME INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-18",
"last_updated": "2021-09-27",
"certification_date": "2021-09-27",
"status": "A",
"authorized_official_last_name": "RAGER",
"authorized_official_first_name": "BRETT",
"authorized_official_title_or_position": "VP REIMBURSEMENT",
"authorized_official_telephone_number": "727-614-8300"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "FL",
"license": "HHA299992690",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Comprehensive Home Care of Palm Beach",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Comprehensive Home Care of Palm Beach",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Port St Lucie, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.