Organization Active NPI

Enhanced Living Consultants Inc

  • Home Modifications Contractor
  • Coconut Creek, FL
National Provider Identifier
1205692696
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Modifications ContractorTaxonomy code 171WH0202X
Legal business name
ENHANCED LIVING CONSULTANTS INC
Practice address
4040 Edgewood Dr
Coconut Creek, FL 33066-1835
Phone
(954) 980-5002
NPI assigned
Feb 23, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Authorized official

Name
Michael Gipson
Title
President
Phone
(954) 980-5002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Modifications ContractorGroup: 193400000X SINGLE SPECIALTY GROUP 171WH0202X Primary

Addresses

Primary practice location

4040 Edgewood Dr
Coconut Creek, FL 33066-1835

Mailing address

4040 Edgewood Dr
Coconut Creek, FL 33066-1835
Phone (954) 980-5002

Other identifiers 2

IdentifierTypeStateIssuer
113563300MedicaidFL
114401600MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1205692696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 EDGEWOOD DR",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661835",
            "telephone_number": "954-980-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 EDGEWOOD DR",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330661835",
            "telephone_number": "954-980-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENHANCED LIVING CONSULTANTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "GIPSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-980-5002"
    },
    "taxonomies": [
        {
            "code": "171WH0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Contractor, Home Modifications",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113563300",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "114401600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.