Concierge Community Care LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

CONCIERGE COMMUNITY CARE LLC

Practice address

8743 S Federal Hwy
Port Saint Lucie, FL 34952-3310

Phone

(754) 234-2836

NPI assigned

Oct 4, 2020

Organization subpart

No

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

Authorized official

Name

Thaysha DutesNPI 1629848676

Title

Ceo

Phone

(754) 234-2836

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thaysha Dutes, RN

  • Nurse Practitioner
  • Port St Lucie, FL
  • NPI 1629848676
  NPD Authorized official

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

{
    "created_epoch": "1601769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601769600000",
    "number": "1982201893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8743 S FEDERAL HWY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349523310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8743 S FEDERAL HWY",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349523310",
            "telephone_number": "754-234-2836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCIERGE COMMUNITY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-04",
        "last_updated": "2020-10-04",
        "certification_date": "2020-10-04",
        "status": "A",
        "authorized_official_last_name": "DUTES",
        "authorized_official_first_name": "THAYSHA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "754-234-2836"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmental Disabilities Clinic/Center in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.