Organization Active NPI

First Choice Advance Mobile Wound Care

  • Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1942176375
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
FIRST CHOICE ADVANCE MOBILE WOUND CARE
Practice address
2833 Exchange CT Ste D
West Palm Beach, FL 33409-4047
Phone
(561) 254-2352
NPI assigned
Oct 13, 2025
Last updated
Oct 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Authorized official

Name
Kettelie Henry, NPNPI 1013576511
Title
Nurse Practitioner
Phone
(561) 254-2352

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

2833 Exchange CT Ste D
West Palm Beach, FL 33409-4047

Mailing address

5645 Opal Dr
Westlake, FL 33470-7063
Phone (561) 254-2352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251203001107 FL Part B Supplier - Clinic/Group Practice 2365935913 Receives reassigned benefits from 1 practitioner
Practice locations: West Palm Beach, FL

National Provider Directory

National Provider Directory

Locations

2833 Exchange Ct
Ste D
West Palm Beach, FL 33409
Phone (561) 216-2175

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": "1760313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760313600000",
    "number": "1942176375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5645 OPAL DR",
            "city": "WESTLAKE",
            "state": "FL",
            "postal_code": "334707063",
            "telephone_number": "561-254-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2833 EXCHANGE CT STE D",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334094047",
            "telephone_number": "561-254-2352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CHOICE ADVANCE MOBILE WOUND CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-13",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "KETTELIE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "561-254-2352",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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 Oct 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.