MEDERI OF ORANGE COUNTY, INC. (NPI# 1376539155) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376539155 |
| Entity Type | Organization |
| Organization Name | MEDERI OF ORANGE COUNTY, INC. |
| Other Organization Name | MEDERI OF BREVARD COUNTY |
| Practice Address |
1071 Port Malabar Blvd Ne Suite 205 Palm Bay FL 32905-5161 |
| Mailing Address |
9510 Ormsby Station Rd Suite 300 Louisville KY 40223-4081 |
| Practice Telephone | 3213080321 |
| Practice Fax Number | 3213080329 |
| Mailing Telephone | 5028911000 |
| Mailing Fax Number | 5028918067 |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. C. STEVEN GUENTHNER (SR. VP,CFO) |
| Authorized Official Telephone | 5028911042 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 21635096 | FL | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | BLUE CROSS-BLUE SHIELD | HE3 | 01 |
| Other Name | Type Code |
|---|---|
| Mederi of Brevard County | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932195088 | Mederi of Orange County, Inc. | Home Health | 555 Winderley Pl, Ste 100, Maitland, FL 32751-7225 | 2005-09-23 |
| Street Address |
1071 PORT MALABAR BLVD NE SUITE 205 |
| City | PALM BAY |
| State | FL |
| Zip Code | 32905-5161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184187908 | Sharon Liz Reed | Psychologist | 1071 Port Malabar Blvd Ne, Palm Bay, FL 32905-5161 | 2019-04-09 |
| 1437625225 | Sivan Emery | Social Worker | 1071 Port Malabar Blvd Ne, Palm Bay, FL 32905-5161 | 2018-10-18 |
| 1346729423 | Delvin L Session | Case Management | 1071 Port Malabar Blvd Ne, Palm Bay, FL 32905-5161 | 2018-08-09 |
| 1790212272 | Angela Marie Narcisse | Case Manager/Care Coordinator | 1071 Port Malabar Blvd Ne, Palm Bay, FL 32905-5161 | 2017-05-16 |
| 1134673825 | Haruna Nail | Point of Service | 1071 Port Malabar Blvd Ne, 106, Palm Bay, FL 32905-5161 | 2016-08-10 |
| 1750835021 | Pamela Anne Loftus | Counselor | 1071 Port Malabar Blvd Ne, Suite 106, Palm Bay, FL 32905-5161 | 2016-08-04 |
| 1013360593 | Vilmarie Roman | Social Worker | 1071 Port Malabar Blvd Ne, N.e. Suite 106, Palm Bay, FL 32905-5161 | 2016-07-19 |
| 1831557974 | Margarita Apolinaris | Social Worker | 1071 Port Malabar Blvd Ne, Palm Bay, FL 32905-5161 | 2016-02-03 |
| 1972925394 | Christopher Bickford | Acupuncturist | 1071 Port Malabar Blvd Ne, Palm Bay, FL 32905-5161 | 2014-01-21 |
| 1568891984 | Tara Clutter | Acupuncturist | 1071 Port Malabar Blvd Ne, Suite 106, Palm Bay, FL 32905-5161 | 2013-11-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306460928 | Lavell Woodard Jr. | Counselor | 4206 Pinewood Dr Ne, Palm Bay, FL 32905 | 2020-05-29 |
| 1548735699 | Aaron J Milton | Counselor | 1420 Sportsman Lane Ne, Palm Bay, FL 32905 | 2018-10-04 |
| 1871070417 | The Brevard Health Alliance Inc | Clinic/Center | 1361 Florida Ave Ne Ste 2, Palm Bay, FL 32905 | 2018-07-26 |
| 1699266361 | Coastal Visioncare LLC | Optometrist | 2186 Harris Ave Ne Ste 1, Palm Bay, FL 32905 | 2018-05-29 |
| 1184173981 | Jean Elyse Gautreaux | Social Worker | 2475 Palm Bay Rd Ne, Suite 130 #4, Palm Bay, FL 32905 | 2016-09-22 |
| 1174901607 | Reginald Shannon Seecharan | Developmental Therapist | 700 James Cir Ne, Palm Bay, FL 32905 | 2015-05-17 |
| 1881091254 | Courtney Taft | Physical Therapy Assistant | 1155 Malabar Road, Suite 1, Palm Bay, FL 32905 | 2014-12-01 |
| 1548513310 | Juda Marie Decara | Counselor | 4690 Lipscomb St Se, Suite 6c, Palm Bay, FL 32905 | 2012-10-18 |
| 1326308313 | Mohammad Idrees Md, P.a. | Internal Medicine | 1454 Belaire Lane N.e., Palm Bay, FL 32905 | 2012-05-23 |
| 1265704548 | Atm Amin Dds LLC | Dentist | 4620 Lipscomb St Ne, Suite 2, Palm Bay, FL 32905 | 2012-02-02 |
| Find all providers in zip 32905 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053939751 | Carissa Long | Home Health | 1638 Hawksbill St Nw, Palm Bay, FL 32907-7127 | 2020-07-09 |
| 1265904791 | Tender At Heart Assisted Living Facility I | Home Health | 1592 Glencove Ave Nw, Palm Bay, FL 32907-8609 | 2018-12-21 |
| 1326516709 | Empowered Community Living LLC | Home Health | 4630 Lipscomb St Ne Ste 2, Palm Bay, FL 32905-2940 | 2018-11-05 |
| 1760857197 | Comfort Cottage Adult Family Care Home | Home Health | 1041 Pembroke Ave Ne, Palm Bay, FL 32907-1310 | 2015-12-10 |
| 1457788085 | Medisource Solutions, LLC | Home Health | 325 Fenton Rd Sw, Palm Bay, FL 32908-4882 | 2013-09-27 |
| 1780840793 | Hearts At Home, Inc | Home Health | 1398 Palm Bay Rd Ne, Palm Bay, FL 32905-3837 | 2008-07-30 |
| 1801096375 | New Horizonrehab | Home Health | 966 Siboney St Nw, Palm Bay, FL 32907-1773 | 2007-07-23 |
| 1780952341 | Brevard Best Care, Inc. | Home Health | 4640 Lipscomb St Ne, Suite # 6, Palm Bay, FL 32905-2986 | 2011-12-09 |
| 1588821664 | Visiting Homecare | Home Health | 4640 Lipscomb St Ne, Suite 15, Palm Bay, FL 32905-2986 | 2008-05-17 |
| 1366563173 | Abel Nursing Agency | Home Health | 1501 Robert J Conlan Blvd Ne, Suite #6, Palm Bay, FL 32905-3502 | 2007-04-02 |
| Find all providers in PALM BAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.