Organization Active NPI

Amandla Wellness Center, LLC

  • Primary Care Clinic/Center
  • Fort Pierce, FL
National Provider Identifier
1144037532
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
AMANDLA WELLNESS CENTER, LLC
Practice address
850 S 21St St Ste M
Fort Pierce, FL 34950-4846
Phone
(772) 708-0273
Fax
(866) 519-0540
NPI assigned
Dec 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Authorized official

Name
Dr. Margaret Lott, MDNPI 1356735393
Title
Ceo/Founder
Phone
(772) 708-0273

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

850 S 21St St Ste M
Fort Pierce, FL 34950-4846

Mailing address

850 S 21St St Ste M
Fort Pierce, FL 34950-4846
Phone (772) 708-0273

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250129002029 FL Part B Supplier - Clinic/Group Practice 3173052693 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Pierce, FL

National Provider Directory

National Provider Directory

Locations

850 S 21st St
Ste M
Fort Pierce, FL 34950
Phone (772) 708-0273

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1734480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1144037532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 S 21ST ST STE M",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504846",
            "telephone_number": "772-708-0273",
            "fax_number": "866-519-0540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S 21ST ST STE M",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349504846",
            "telephone_number": "772-708-0273",
            "fax_number": "866-519-0540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMANDLA WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-18",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "LOTT",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "CEO/FOUNDER",
        "authorized_official_telephone_number": "772-708-0273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.