Individual provider Active NPI

Carlos Coloma, APRN

  • Family Nurse Practitioner
  • Wellington, FL
National Provider Identifier
1124442314
Registry record updated Feb 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN9371022 Issued in FL
Practice address
3319 S State Road 7 Ste 102
Wellington, FL 33449-8099
Phone
(561) 333-4000
Fax
(561) 333-8851
NPI assigned
Feb 10, 2014
Last updated
Feb 14, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9371022 FL Primary

Addresses

Primary practice location

3319 S State Road 7 Ste 102
Wellington, FL 33449-8099

Mailing address

367 S. Gulph Rd
Attn: Ipm Credentialing
King of Prussia, PA 19406-3121
Phone (561) 333-4000

Other practice location 1

13421 S Shore Blvd Ste 101
Wellington, FL 33414-7210
Phone (561) 440-1616

Other practice location 2

330 S Dixie Hwy
suite 3
Lake Worth, FL 33460-4400
Phone (561) 275-1155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151106000280 FL Practitioner - Nurse Practitioner 0244540011 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN9371022FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Boynton Urgent Care, LLC CurrentSince Apr 23, 2017 Accepting new patients
Solantic of Jacksonville, LLC CurrentSince Jul 6, 2015 Accepting new patients
Shands/Solantic Joint Venture, LLC CurrentSince Jul 6, 2015 Accepting new patients
Hma/Solantic Joint Venture, LLC CurrentSince Jul 6, 2015 Accepting new patients
Solantic/South Florida, LLC CurrentSince Jul 6, 2015 Accepting new patients
Soma Medical Center, P. a #4 Past Accepting new patients

Locations

8756 Boynton Rd W
Ste 150
Boynton Beach, FL 33472
Phone (561) 740-2273

720 SW 2nd Ave
Ste 160A
Gainesville, FL 32601
Phone (352) 240-8000

13460 Beach Blvd
Ste 1
Jacksonville, FL 32224
Phone (904) 854-1700

2401 Monument Rd
Jacksonville, FL 32225
Phone (904) 642-0337

2415 SW College Rd
Ocala, FL 34471
Phone (352) 237-3536

9035 Pines Blvd
Pembroke Pines, FL 33024
Phone (954) 340-5881

1611 S Federal Hwy
Pompano Beach, FL 33062
Phone (954) 580-4001

1820 58th Ave
Ste 110
Vero Beach, FL 32966
Phone (772) 257-3200

463941 State Road 200
Yulee, FL 32097
Phone (904) 572-1959

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AWCHU1
  • FHIR API: https://fhir4.healow.com/fhir/r4/DDCGDD/Endpoint/DDCGDD

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1124442314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S. GULPH RD",
            "address_2": "ATTN: IPM CREDENTIALING",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "561-333-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 S STATE ROAD 7 STE 102",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334498099",
            "telephone_number": "561-333-4000",
            "fax_number": "561-333-8851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13421 S Shore Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Wellington",
            "state": "FL",
            "postal_code": "334147210",
            "country_code": "US",
            "telephone_number": "561-440-1616",
            "fax_number": "561-440-2030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 S Dixie Hwy",
            "address_2": "suite 3",
            "address_purpose": "LOCATION",
            "city": "Lake Worth",
            "state": "FL",
            "postal_code": "334604400",
            "country_code": "US",
            "telephone_number": "561-275-1155",
            "fax_number": "561-275-1156",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLOMA",
        "first_name": "CARLOS",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-10",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9371022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.