Active NPI
Andell Y Phillip
- Homemaker
- Lake Mary, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Homemaker
- License
- 239577
- Practice address
- 1540 International Pkwy Ste 2000
Lake Mary, FL 32746-5096 - Phone
- (352) 502-4923
- Fax
- (352) 504-0241
- NPI assigned
- Feb 2, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 166697 | FL | |
| Homemaker | 376J00000X | 239577 | FL | Primary |
Addresses
Primary practice location
1540 International Pkwy Ste 2000
Lake Mary, FL 32746-5096
Mailing address
8810 SW Highway 200 Unit 124
Ocala, FL 34481-7822
Phone (352) 502-4923
Other practice location 1
7402 N 56th St Ste 100H
Tampa, FL 33617-7746
Phone (813) 733-7497
Other practice location 2
8810 SW Highway 200 Unit 124
Ocala, FL 34481-7822
Phone (352) 502-4923
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 239577 | FL | MD | Homemaker |
| 166697 | FL | MD | Nurse's Aide |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ourlove Senior Care Inc. | Current | Accepting new patients | |
| Amlove Senior Care Inc | Current | Accepting new patients |
Locations
1540 International Pkwy
Ste 2000
Lake Mary, FL 32746
Phone (407) 287-9179
8810 SW Highway 200
Unit 124
Ocala, FL 34481
Phone (352) 502-4923
7402 N 56th St
Ste 100H
Tampa, FL 33617
Phone (813) 733-4977
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Long Term Care Hospital
- Ocala, FL
- NPI 1306475272
-
- In Home Supportive Care Agency
- Summerfield, FL
- NPI 1497446710
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701388800000",
"number": "1922563030",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8810 SW HIGHWAY 200 UNIT 124",
"city": "OCALA",
"state": "FL",
"postal_code": "344817822",
"telephone_number": "352-502-4923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1540 INTERNATIONAL PKWY STE 2000",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327465096",
"telephone_number": "352-502-4923",
"fax_number": "352-504-0241"
}
],
"practiceLocations": [
{
"address_1": "7402 N 56th St Ste 100H",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336177746",
"country_code": "US",
"telephone_number": "813-733-7497",
"fax_number": "352-504-0241",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8810 SW Highway 200 Unit 124",
"address_purpose": "LOCATION",
"city": "Ocala",
"state": "FL",
"postal_code": "344817822",
"country_code": "US",
"telephone_number": "352-502-4923",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHILLIP",
"first_name": "ANDELL",
"middle_name": "Y",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-02-02",
"last_updated": "2023-12-01",
"certification_date": "2023-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "FL",
"license": "166697",
"primary": false
},
{
"code": "376J00000X",
"taxonomy_group": "",
"desc": "Homemaker",
"state": "FL",
"license": "239577",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lake Mary, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.