Walk-in Wellness Center PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

WALK-IN WELLNESS CENTER PLLC

Practice address

1645 Palm Beach Lakes Blvd Ste 1200
West Palm Beach, FL 33401-2214

Phone

(561) 207-2047

NPI assigned

Mar 27, 2019

Last updated

Jul 24, 2020By 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

Ebony Davis, M.D.

Title

Ceo

Phone

(205) 200-5110

Specialties & licenses 4

Addresses

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595548800000",
    "number": "1245791631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 LAKE WORTH RD STE 213-214",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334672955",
            "telephone_number": "561-444-2351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 PALM BEACH LAKES BLVD STE 1200",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012214",
            "telephone_number": "561-207-2047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1645 Palm Beach Lakes Blvd Ste 1200",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334012214",
            "country_code": "US",
            "telephone_number": "205-200-5110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WALK-IN WELLNESS CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-27",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "EBONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "205-200-5110",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in West Palm Beach, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; 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.