Platinum Wellness LLC

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

PLATINUM WELLNESS LLC

Practice address

1213 Piper Blvd
Naples, FL 34110-1393

Phone

(239) 254-0099

Fax

(239) 254-1908

NPI assigned

Apr 5, 2022

Organization subpart

No

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

Authorized official

Name

Krystine Swannick-Konopczynski, MD

Title

Practice Owner

Phone

(239) 254-0099

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Platinum Wellness Doing business as

Locations

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1265173157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1213 PIPER BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101393",
            "telephone_number": "239-254-0099",
            "fax_number": "239-254-1908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1213 PIPER BLVD",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341101393",
            "telephone_number": "239-254-0099",
            "fax_number": "239-254-1908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "SWANNICK-KONOPCZYNSKI",
        "authorized_official_first_name": "KRYSTINE",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "239-254-0099",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275067800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Platinum Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Platinum Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nephrology Physician in Naples, FL
• Providers in Naples, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.