JACKSONVILLE HEALTH AND REHABILITATION, LLC (NPI# 1033166640) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033166640 |
| Entity Type | Organization |
| Organization Name | JACKSONVILLE HEALTH AND REHABILITATION, LLC |
| Practice Address |
410 Wilson Dr Sw Jacksonville AL 36265-2754 |
| Practice Telephone | 2564357704 |
| Mailing Telephone | 2564357704 |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2020-10-12 |
| Authorized Official Name | PHILLIP CODY LONG (CFO) |
| Authorized Official Telephone | 2053913600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 4757820S | 05 | |
| AL | BCBS ID | 012231 | 01 |
| Street Address |
410 WILSON DR SW |
| City | JACKSONVILLE |
| State | AL |
| Zip Code | 36265-2754 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568075067 | Danyel L Munster | Nurse Practitioner | 410 Wilson Dr Sw, Jacksonville, AL 36265-2754 | 2020-08-25 |
| 1831389774 | Lisa Sanford Lumpkin | Occupational Therapist | 410 Wilson Dr Sw, Jacksonville, AL 36265-2754 | 2007-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700436144 | Griffin Loflin | Specialist/Technologist | 775 Park Ave Nw, Attn. Sports Medicine, Jacksonville, AL 36265 | 2019-09-17 |
| 1114304011 | Caroline Ross | Counselor | 1215 Jackson Way Sw, Jacksonville, AL 36265 | 2015-04-29 |
| 1083001226 | Tracey Hudgins | Counselor | 1215 Jackson's Way, Jacksonville, AL 36265 | 2015-04-24 |
| 1235415118 | Adam Pike | Pharmacist | 311 Pelham Rd So, Jacksonville, AL 36265 | 2011-10-24 |
| 1386829489 | Physicians Choice Dialysis of Jacksonville, LLC | Clinic/Center | 331 Henry Road Sw, Jacksonville, AL 36265 | 2008-01-08 |
| 1659409365 | Kenneth Wayne Campbell | Nurse Anesthetist, Certified Registered | 1701 Pelham Road, Jacksonville Medical Center, Jacksonville, AL 36265 | 2007-03-02 |
| 1154478378 | Diana C. Ford | Counselor | 1250 Jackson's Way, Garrett Counseling Center, Jacksonville, AL 36265 | 2007-01-03 |
| 1487710950 | James Richard Morrison | Chiropractor | 1550 Pelham Rd. S., Jacksonville, AL 36265 | 2006-12-29 |
| 1447332937 | Millennium Anesthesia Services | Anesthesiology | 1701 Pelham Road S, Jacksonville, AL 36265 | 2006-10-20 |
| 1407943228 | Brunda Revanna, Md | Clinic/Center | 1465 A 1st Ave Sw Ste C, Jacksonville, AL 36265 | 2006-10-05 |
| Find all providers in zip 36265 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1992336895 | Dolphin Pointe Health Care, LLC | Skilled Nursing Facility | 5355 Dolphin Point Rd., Jacksonville, FL 32211 | 2020-01-29 |
| 1629439260 | West Jax Geriatrics, LLC | Skilled Nursing Facility | 730 College St, Jacksonville, FL 32204-3313 | 2016-03-10 |
| 1376955377 | Edwin Bato | Skilled Nursing Facility | 3434 Nightscape Cir, Jacksonville, FL 32224-1618 | 2014-05-24 |
| 1508138678 | Terri Velinda Virgil | Skilled Nursing Facility | 11555 Birch Forest Circle East, Jacksonville, FL 32218 | 2012-02-03 |
| 1689993032 | Jacksonville Scc, LLC | Skilled Nursing Facility | 810 Bellaire St, Jacksonville, TX 75766-9045 | 2010-05-25 |
| 1326362005 | Brooks Skilled Nursing Facility, A, Inc. | Skilled Nursing Facility | 6209 Brooks Bartram Dr. Bldg 100, Jacksonville, FL 32258 | 2010-03-24 |
| 1144476946 | Magnus Opus Technology | Skilled Nursing Facility | 7000 Northlake Dr, Jacksonville, AR 72076-4959 | 2008-08-12 |
| 1972796175 | Russell Wayne Tolliver | Skilled Nursing Facility | 4083 Sunbeam Rd, Apartment 1409, Jacksonville, FL 32257-8993 | 2007-08-21 |
| 1750409082 | Patti Sperling Arnp LLC | Skilled Nursing Facility | 402 Myrtlewood Cir, Jacksonville, NC 28546-7412 | 2007-03-26 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 36265 |
Please comment or provide details below to improve the information on JACKSONVILLE HEALTH AND REHABILITATION, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.