Organization Active NPI

GV Port Charlotte, LLC

Doing business as Grand Villa of Port Charlotte

  • Assisted Living Facility
  • Port Charlotte, FL
National Provider Identifier
1184428435
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
GV PORT CHARLOTTE, LLC
Doing business as
Grand Villa of Port Charlotte
Practice address
2500 Aaron St
Port Charlotte, FL 33952-6743
Phone
(941) 627-6762
NPI assigned
Apr 3, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Authorized official

Name
Robin Monthie
Title
Operations Manager
Phone
(727) 726-3980

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary
Alzheimer Center (Dementia Center) 311500000X

Addresses

Primary practice location

2500 Aaron St
Port Charlotte, FL 33952-6743

Mailing address

13770 58TH St N Ste 312
Clearwater, FL 33760-3759
Phone (727) 726-3980

Other names 1

  • Grand Villa of Port Charlotte Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2210480Grand Villa of Port Charlotte2500 Aaron St, Port Charlotte, FL 33952Certificate of waiverJan 20, 2027

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1743638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743638400000",
    "number": "1184428435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13770 58TH ST N STE 312",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337603759",
            "telephone_number": "727-726-3980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 AARON ST",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339526743",
            "telephone_number": "941-627-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GV PORT CHARLOTTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-03",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A",
        "authorized_official_last_name": "MONTHIE",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "727-726-3980"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Villa of Port Charlotte",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.