NPIMap

Organization Active NPI

GV Palm Coast, LLC

Doing business as Grand Villa of Palm Coast

  • Assisted Living Facility
  • Palm Coast, FL
National Provider Identifier
1679172563
Registry record updated Oct 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
GV PALM COAST, LLC
Doing business as
Grand Villa of Palm Coast
Practice address
100 Magnolia Trace Way
Palm Coast, FL 32164-2382
Phone
(386) 445-3500
NPI assigned
Oct 21, 2020
Last updated
Oct 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2020

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

Authorized official

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

100 Magnolia Trace Way
Palm Coast, FL 32164-2382

Mailing address

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

Other names 1

  • Grand Villa of Palm Coast Doing business as

National Provider Directory

National Provider Directory
Tax ID family
GV Clearwater LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603238400000",
    "number": "1679172563",
    "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": "100 MAGNOLIA TRACE WAY",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321642382",
            "telephone_number": "386-445-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GV PALM COAST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A",
        "authorized_official_last_name": "MONTHIE",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "SENIOR OPERATIONS COORDINATOR",
        "authorized_official_telephone_number": "727-726-3980"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Villa of Palm Coast",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.