PROVIDENT HOME CARE, INC. (NPI# 1831662022) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831662022 |
| Entity Type | Organization |
| Organization Name | PROVIDENT HOME CARE, INC. |
| Practice Address |
4934 17th Ave N St Petersburg FL 33710-5202 |
| Mailing Address |
123 Pebble Creek Rd Franklin TN 37064-5525 |
| Practice Telephone | 6153470900 |
| Mailing Telephone | 6153470900 |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2019-01-10 |
| Authorized Official Name | DAVID E WILSON (OWNER/CFO) |
| Authorized Official Telephone | 6153470900 |
| Authorized Official Credential | CPA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| Street Address |
4934 17TH AVE N |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33710-5202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023615812 | Bay Vision Inc | Optometrist | 6951 22nd Ave North, St. Petersburg, FL 33710 | 2020-10-05 |
| 1821566845 | Harish J. Patel, Md | Non-Pharmacy Dispensing Site | 6449 38th Avenue North, Suite B3, Saint Petersburg, FL 33710 | 2018-11-07 |
| 1659860708 | Lydia M Gomez | Physical Therapist | 6775 Crosswinds Dr. N, Saint Petersburg, FL 33710 | 2018-05-04 |
| 1619498169 | Tiffiny C Rudkin | Massage Therapist | 3039 - 49th St. N., St. Petersburg, FL 33710 | 2017-07-05 |
| 1114456480 | Roberto Macedo Dentistry LLC | Dentist | 7801 38th Ave North, St. Petersburg, FL 33710 | 2017-06-08 |
| 1528429495 | Frank Michael Massotto Jr. | Nurse Practitioner | 3251 66th St. North, St Petersburg, FL 33710 | 2016-03-18 |
| 1235522889 | Toby Weinman Assisted Living Residence | Assisted Living Facility | 240 59th St N, St Petersburg, FL 33710 | 2015-03-06 |
| 1821415951 | Ryan Troup | Physician Assistant | 603 - 7th St. S, Suite 360, Emergency Physicians of Saint Petersburg, Saint Petersburg, FL 33710 | 2014-03-26 |
| 1629491600 | Garett Janes Sears | Psychologist | 1913 Tyrone Blvd, St. Petersburg, FL 33710 | 2014-01-28 |
| 1912331943 | Solimar Jimenez Diaz | Obstetrics & Gynecology | 6450 38th Ave N Ste 200, St Petersburg, FL 33710 | 2013-08-27 |
| Find all providers in zip 33710 | ||||
| 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 |
|---|---|---|---|---|
| 1174135727 | K2d3 Enterprise LLC | Home Health | 5959 Central Ave Ste 403, St Petersburg, FL 33710-8502 | 2020-08-17 |
| 1073121471 | Aloe At Home LLC | Home Health | 835 Newton Ave S, St Petersburg, FL 33701-5325 | 2020-07-21 |
| 1144842162 | Jilliann Rae Lunn | Home Health | 3520 56th Ave N, St Petersburg, FL 33714-1849 | 2020-05-13 |
| 1376175208 | David Phandara | Home Health | 3031 14th St N, St Petersburg, FL 33704-1914 | 2020-02-09 |
| 1659923472 | Covenant Home Health Care 5, LLC | Home Health | 2546 22nd Ave N, St Petersburg, FL 33713-4311 | 2019-07-11 |
| 1407415839 | Helping Hands Priority Home Care Services, Inc | Home Health | 295 15th St N, St Petersburg, FL 33705-2013 | 2019-06-10 |
| 1730646605 | Gulf Breeze Home Health, Inc. | Home Health | 111 2nd Ave N Ste 355, St Petersburg, FL 33701-3315 | 2019-02-26 |
| 1518424910 | Florida Homecare Specialists Minority Corp | Home Health | 1211 1st Ave N. Mezzanine Ste 215, St Petersburg, FL 33705-1567 | 2019-02-22 |
| 1639633175 | Harmony Garden, LLC | Home Health | 4601 6th Ave S, St Petersburg, FL 33711-1801 | 2019-01-29 |
| 1326519232 | Southern Oasis Homecare LLC | Home Health | 2604 Central Ave, St Petersburg, FL 33712-1152 | 2018-12-17 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33710 |
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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.