Authentic Healthcare, LLC

Primary specialty

HomemakerTaxonomy code 376J00000X

Legal business name

AUTHENTIC HEALTHCARE, LLC

Doing business as

Authentic Healthcare of Jax, LLC

Practice address

8576 Arlington Expy
Jacksonville, FL 32211-8003

Phone

(904) 802-5267

NPI assigned

Aug 26, 2020

Last updated

Jul 21, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Johanna I Gates

Title

RN

Phone

(904) 802-5267

Specialties & licenses 1

Addresses

Other names 1

• Authentic Healthcare of Jax, LLC Doing business as

Locations

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

{
    "created_epoch": "1598400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1942813233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8576 ARLINGTON EXPY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322118003",
            "telephone_number": "904-802-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8576 ARLINGTON EXPY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322118003",
            "telephone_number": "904-802-5267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUTHENTIC HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-26",
        "last_updated": "2021-07-21",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "GATES",
        "authorized_official_first_name": "JOHANNA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "904-802-5267"
    },
    "taxonomies": [
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Authentic Healthcare of Jax, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Authentic Healthcare of Jax, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Homemaker in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Homemaker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; 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.