Avanti Home Health of Palm Beach Corp

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

299993913 Issued in FL

Legal business name

AVANTI HOME HEALTH OF PALM BEACH CORP

Practice address

1015 Gateway Blvd Ste 502
Boynton Beach, FL 33426-8347

Phone

(561) 733-1390

Fax

(561) 739-9456

NPI assigned

May 11, 2011

Last updated

Dec 1, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Mark Conklin

Title

Owner, Ceo

Phone

(561) 733-1390

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104118975. Details of each certification follow.

• CCN 683189 Home health agency · Active · Details

Home health agency certification: CCN 683189

Legal name

AVANTI HOME HEALTH OF PALM BEACH CORP

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 1, 2015

Last certification

Nov 6, 2020

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Feb 17, 2011 in FL

Enrollment address

1015 Gateway Bivd
Suite 502
Boynton Beach, FL 33426

Listed as

Avanti Home Health of Palm Beach CorpCCN 683189 · All quality measures

Overall star rating

2.5 of 5

Ownership

Proprietary

Certified

Mar 1, 2015

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Physical therapy, Speech pathology, Occupational therapy

Locations

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Natacha Blanchet, FNP-BC

  • Family Nurse Practitioner
  • West Palm Beach, FL
  • NPI 1346718947

  Home health agency

  Care Compare affiliation

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1104118975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 GATEWAY BLVD STE 502",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334268347",
            "telephone_number": "561-733-1390",
            "fax_number": "561-739-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 GATEWAY BLVD STE 502",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334268347",
            "telephone_number": "561-733-1390",
            "fax_number": "561-739-9456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANTI HOME HEALTH OF PALM BEACH CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER, CEO",
        "authorized_official_telephone_number": "561-733-1390",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299993913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113570300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Boynton Beach, FL
• Providers in Boynton Beach, FL by specialty
• Home Health Agency in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.