Organization Active NPI

Consortia Health Long Term Care LLC

  • Family Medicine Physician
  • West Palm Beach, FL
National Provider Identifier
1689152779
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CONSORTIA HEALTH LONG TERM CARE LLC
Practice address
1645 Palm Beach Lakes Blvd Ste 1200
West Palm Beach, FL 33401-2214
Phone
(888) 375-0219
Fax
(888) 712-4684
NPI assigned
Aug 1, 2018
Last updated
Dec 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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

Authorized official

Name
Amanda Whelpley
Title
Ceo
Phone
(561) 876-3767

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Dietary ManagerGroup: 193200000X MULTI-SPECIALTY GROUP 132700000X
Administrator Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WA2000X
Continence Care Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WC2100X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Urology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208800000X
Nursing Care Agency 251J00000X
Durable Medical Equipment & Medical Supplies 332B00000X
Gerontology Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LG0600X

Addresses

Primary practice location

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

Mailing address

1645 Palm Beach Lakes Blvd Ste 1200
West Palm Beach, FL 33401-2214
Phone (888) 375-0219

Other practice location 1

501 Congress Ave Ste 150
Austin, TX 78701-3575
Phone (888) 375-0219

National Provider Directory

National Provider Directory

Locations

1645 Palm Beach Lakes Blvd
Ste 240
West Palm Beach, FL 33401
Phone (561) 329-3198

111 Congress Ave
Ste 400
Austin, TX 78701
Phone (888) 375-0219

501 Congress Ave
Ste 105
Austin, TX 78701
Phone (888) 375-0219

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": "1533081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609113600000",
    "number": "1689152779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 PALM BEACH LAKES BLVD STE 1200",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012214",
            "telephone_number": "888-375-0219",
            "fax_number": "888-712-4684"
        },
        {
            "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": "888-375-0219",
            "fax_number": "888-712-4684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Congress Ave Ste 150",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787013575",
            "country_code": "US",
            "telephone_number": "888-375-0219",
            "fax_number": "888-712-4684",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CONSORTIA HEALTH LONG TERM CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-01",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A",
        "authorized_official_last_name": "WHELPLEY",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-876-3767"
    },
    "taxonomies": [
        {
            "code": "132700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietary Manager",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Administrator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WC2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Continence Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.