NPIMap

Organization Active NPI

Caretenders Visiting Services of St. Augustine, LLC

  • In Home Supportive Care Agency
  • Ormond Beach, FL
National Provider Identifier
1992269401
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
CARETENDERS VISITING SERVICES OF ST. AUGUSTINE, LLC
Practice address
200 E Granada Blvd Ste 208
Ormond Beach, FL 32176-6692
Phone
(386) 615-2053
Fax
(386) 676-2173
NPI assigned
Jan 29, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Authorized official

Name
Joshua L Proffitt
Title
President
Phone
(337) 233-1307

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

200 E Granada Blvd Ste 208
Ormond Beach, FL 32176-6692

Mailing address

PO Box 51266
Lafayette, LA 70505-1266
Phone (337) 233-1307

Other identifiers 1

IdentifierTypeStateIssuer
104088500MedicaidFL

Other names 1

  • Apex Companion Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Apex Companion Care4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

200 E Granada Blvd
Ste 208
Ormond Beach, FL 32176
Phone (386) 615-2053

1425 Hand Ave
Ste I2
Ormond Beach, FL 32174

NPI Registry JSON

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696896000000",
    "number": "1992269401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51266",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705051266",
            "telephone_number": "337-233-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E GRANADA BLVD STE 208",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321766692",
            "telephone_number": "386-615-2053",
            "fax_number": "386-676-2173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARETENDERS VISITING SERVICES OF ST. AUGUSTINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-29",
        "last_updated": "2023-10-10",
        "certification_date": "2023-10-10",
        "status": "A",
        "authorized_official_last_name": "PROFFITT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-233-1307"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104088500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Apex Companion Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Apex Companion Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.

Verify at the official NPI Registry.