Active NPI
Rolling Tides Recovery LLC
- Primary Care Nurse Practitioner
- Tarpon Springs, FL
National Provider Identifier
1891489654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- Legal business name
- ROLLING TIDES RECOVERY LLC
- Practice address
- 620 N Florida Ave
Tarpon Springs, FL 34689-2109 - Phone
- (727) 328-4567
- NPI assigned
- Jun 5, 2023
- 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
- Rachel Hardwick
- Title
- Owner
- Phone
- (727) 328-4567
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Mental Health Clinic/Center | 261QM0850X | |||
| Primary Care Clinic/Center | 261QP2300X | |||
| Primary Care Nurse Practitioner | 363LP2300X | Primary |
Addresses
Primary practice location
620 N Florida Ave
Tarpon Springs, FL 34689-2109
Mailing address
620 N Florida Ave
Tarpon Springs, FL 34689-2109
Phone (727) 328-4567
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685923200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1713484800000",
"number": "1891489654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 N FLORIDA AVE",
"city": "TARPON SPRINGS",
"state": "FL",
"postal_code": "346892109",
"telephone_number": "727-328-4567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 N FLORIDA AVE",
"city": "TARPON SPRINGS",
"state": "FL",
"postal_code": "346892109",
"telephone_number": "727-328-4567"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROLLING TIDES RECOVERY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-06-05",
"last_updated": "2024-04-19",
"certification_date": "2024-04-19",
"status": "A",
"authorized_official_last_name": "HARDWICK",
"authorized_official_first_name": "RACHEL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "727-328-4567"
},
"taxonomies": [
{
"code": "261QM0850X",
"taxonomy_group": "",
"desc": "Clinic/Center, Adult Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": false
},
{
"code": "363LP2300X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tarpon Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.