RADIANT RECHARGE LLC NPI 1366204927

NPI Information

  • NPI: 1366204927
  • Provider Name: RADIANT RECHARGE LLC
  • Classification: Registered Nurse - 163WH0200X
  • Specialization: Home Health
  • Entity Type: Organization
  • CLIA Number: 10D2300231
  • Address: 466 SW PORT ST LUCIE BLVD STE 114
    PORT ST LUCIE, FL
    ZIP 34953
  • Phone: (772) 837-0500

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NPI Details

RADIANT RECHARGE LLC is a home health registered nurse in Port St Lucie, FL. RADIANT RECHARGE LLC NPI is 1366204927. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

466 SW PORT ST LUCIE BLVD STE 114
PORT ST LUCIE, FL
ZIP 34953-091
Phone: (772) 837-0500

The provider's authorized official is Jessica L Frazier .
The authorized official title is Coo and has the following contact phone number (309) 712-1815.

The CLIA number assigned to this NPI record is 10D2300231 - other - home health agency exempt with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/29/2024 and was last updated on 1/29/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1163WC1500XRegistered NurseCommunity HealthNo
2246RP1900XTechnician, PathologyPhlebotomyNo
3251J00000XNursing CareNo
4251K00000XPublic Health or WelfareNo
5163WH0200XRegistered NurseHome HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11093305062OTHERILLINOISREGISTERED NURSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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