SRC HOMECARE, INC. (NPI# 1891301750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891301750 |
| Entity Type | Organization |
| Organization Name | SRC HOMECARE, INC. |
| Practice Address |
1102 8th St Ste A Kirkland WA 98033-5666 |
| Practice Telephone | 2067771190 |
| Practice Fax Number | 2064203835 |
| Mailing Telephone | 2067771190 |
| Mailing Fax Number | 2064203835 |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-09-16 |
| Authorized Official Name | STEVEN CLEELAND (PRESIDENT/CEO) |
| Authorized Official Telephone | 2067771190 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 364SH0200X |
Clinical Nurse Specialist Specialization: Home Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 374U00000X | Home Health Aide | Nursing Service Related Providers | ||
| N | 163WI0500X |
Registered Nurse Specialization: Infusion Therapy |
Nursing Service Providers | ||
| Y | 163WH0200X |
Registered Nurse Specialization: Home Health |
Nursing Service Providers |
| Other Name | Type Code |
|---|---|
| BrightStar Care of Bellevue & North Seattle | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | SRC HOMECARE, INC. | 7331 Avalon Blvd, Alpharetta, GA 30009-2503 |
| Street Address |
1102 8TH ST STE A |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98033-5666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584826 | Raquel Maria Reyes | Interpreter | 11205 Ne 62nd St., Kirkland, WA 98033 | 2020-10-02 |
| 1588146468 | Lake Washington Family Chiropractic, Pllc | Chiropractor | 816 6th Street South, 816 6th Street South, Kirkland, WA 98033 | 2018-09-06 |
| 1316463557 | Tony Jia Ly | Pharmacist | 7224 120th Ave Ne, Kirkland, WA 98033 | 2017-08-18 |
| 1003356403 | Eden Home Health of King County, LLC | Home Health | 733 7th Avenue, Suite 110, Kirkland, WA 98033 | 2017-03-03 |
| 1184170763 | Kirkland Family Dentistry | Dentist | 1715 Market St #104, Kirkland, WA 98033 | 2016-09-01 |
| 1144688565 | Kamala Psychology and Yoga LLC | Psychologist | 603 4th Ave Ste 101, Kirkland, WA 98033 | 2016-01-30 |
| 1245695352 | Ron Massey | Massage Therapist | 11406 Ne 112th St, Kirkland, WA 98033 | 2015-12-17 |
| 1194106039 | John Pham | Internal Medicine | 9426 116th Ave Ne, Kirkland, WA 98033 | 2015-06-16 |
| 1992199970 | Garrison Patrick Wier | Ophthalmology | 625 4th Ave Ste 301, Kirkland, WA 98033 | 2015-03-26 |
| 1871993113 | Abigail Trajtenberg Loomis | Behavioral Analyst | 1003 7th Avenue, Kirkland, WA 98033 | 2014-08-22 |
| Find all providers in zip 98033 | ||||
| Taxonomy Code | 163WH0200X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Home Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912505785 | Tsegereda Thrunh Adal | Registered Nurse | 14800 46th Ave S, Tukwila, WA 98168-4442 | 2020-10-14 |
| 1578161519 | Bintou Sanneh | Registered Nurse | 2914 84th Dr Ne, Marysville, WA 98270-6891 | 2020-10-12 |
| 1053949057 | Kari Mclaughlin | Registered Nurse | 19320 8th Pl W, Lynnwood, WA 98036-7259 | 2020-03-27 |
| 1841824471 | Stargait Medford Physical Therapy, LLC | Registered Nurse | 16420 Se Mcgillivray Blvd Ste 103-355, Vancouver, WA 98683-3461 | 2020-02-21 |
| 1225660624 | Heidi Jo Cunningham | Registered Nurse | 3410 Ne 127th Ave, Vancouver, WA 98682-7654 | 2020-02-04 |
| 1932740594 | Silvia Aracely Ortiz | Registered Nurse | 7205 Mission Rd, Everson, WA 98247-9715 | 2019-10-04 |
| 1780232488 | Andrea Nicol Bailey | Registered Nurse | 14615 Ne N Woodinville Way Ste 108, Woodinville, WA 98072-8492 | 2019-08-27 |
| 1164081576 | Cassandra Moore | Registered Nurse | 3863 Seabeck Holly Rd Nw, Seabeck, WA 98380-9227 | 2019-06-10 |
| 1336608082 | Annie G Ndungu | Registered Nurse | 35806 30th Ave S, Federal Way, WA 98003-7674 | 2019-03-12 |
| 1124538541 | Reliable Healthcare LLC | Registered Nurse | 719 Jadwin Ave Ste 11, Richland, WA 99352-4217 | 2017-10-11 |
| Find all providers with the same taxonomy | ||||
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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.