Organization Active NPI

D'Martinez Home Health Inc

  • Home Health Agency
  • Tampa, FL
National Provider Identifier
1922473404
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
D'MARTINEZ HOME HEALTH INC
Practice address
1936 W Martin Luther King Blvd
#210
Tampa, FL 33607
Phone
(813) 873-9000
NPI assigned
Dec 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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

Authorized official

Name
Peace Eziakonwa
Title
Owner
Phone
(813) 873-9000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1936 W Martin Luther King Blvd
#210
Tampa, FL 33607

Mailing address

1936 W Martin Luther King Blvd
#210
Tampa, FL 33607
Phone (813) 873-9000

Other names 1

  • Chrisdor Home Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221214002943 FL Part A Provider - Home Health Agency 7517252141 Practice locations: Tampa, FL

Home health agency certification: CCN 687236

Legal name
D'MARTINEZ HOME HEALTH INC
Doing business as
CHRISDOR HOME HEALTH
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Mar 10, 2023
Last certification
Mar 3, 2023
Organization structure
CorporationProprietary
Incorporated
Sep 3, 2015 in FL
Enrollment address
1936 W Dr Martin Luther King Jr Blvd
Ste 210
Tampa, FL 33607-6530
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Chrisdor Home HealthCCN 687236
Ownership
-
Certified
Mar 10, 2023
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2107106D Martinez Home Health Inc1936 W Martin Luther King Jr Ste 210, Tampa, FL 33607Certificate of waiverJan 5, 2028

National Provider Directory

National Provider Directory

Locations

1936 W Mlk Blvd
Ste 210
Tampa, FL 33607
Phone (813) 873-9000

Ownership & related parties

All disclosed owners & managing parties 1

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Peace Eziakonwa Individual 5% Or Greater Direct Ownership Interest Dec 4, 2017 100%
Corporate Officer Dec 4, 2017 100%
W-2 Managing Employee Dec 4, 2017 100%
Operational/Managerial ControlD.O.N Dec 4, 2017 100%

NPI Registry JSON

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599091200000",
    "number": "1922473404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 W MARTIN LUTHER KING BLVD",
            "address_2": "#210",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33607",
            "telephone_number": "813-873-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936 W MARTIN LUTHER KING BLVD",
            "address_2": "#210",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33607",
            "telephone_number": "813-873-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D'MARTINEZ HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-09",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A",
        "authorized_official_last_name": "EZIAKONWA",
        "authorized_official_first_name": "PEACE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-873-9000"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chrisdor Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.