Village Veranda at Lady Lake, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

VILLAGE VERANDA AT LADY LAKE, LLC

Doing business as

Village Veranda at Lady Lake

Practice address

955 S US Highway 441
Lady Lake, FL 32159-5208

Phone

(352) 751-5494

NPI assigned

Dec 5, 2019

Last updated

Feb 26, 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

Seth Walker

Title

Cfo

Phone

(850) 583-7990

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• VILLAGE VERANDA AT LADY LAKE Doing business as

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1780221077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2573 BARRINGTON CIR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323086805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 S US HIGHWAY 441",
            "city": "LADY LAKE",
            "state": "FL",
            "postal_code": "321595208",
            "telephone_number": "352-751-5494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE VERANDA AT LADY LAKE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-05",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "SETH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "850-583-7990"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCA ALF LICENSE",
            "identifier": "13312",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104709300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VILLAGE VERANDA AT LADY LAKE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VILLAGE VERANDA AT LADY LAKE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Village Wellness LLC (Village Wellness)
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• Villages RX Pharmacy LLC (Wellcare Pharmacy)
• Villages RX Pharmacy LLC (Wellcaize Pharmacy)

• Assisted Living Facility in Lady Lake, FL
• Providers in Lady Lake, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.