ANTHEM LAKES (NPI# 1093222515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093222515 |
| Entity Type | Organization |
| Organization Name | ANTHEM LAKES |
| Practice Address |
905 Assisi Ln Jacksonville FL 32233-2972 |
| Practice Telephone | 9047467220 |
| Mailing Telephone | 9047467220 |
| Enumeration Date | 2018-01-05 |
| Last Update Date | 2018-01-05 |
| Authorized Official Name | MR. JOHNPAUL LOUIS GOODE (OPERATIONS LIAISON) |
| Authorized Official Telephone | 8048396946 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | 12972 | Nursing & Custodial Care Facilities |
| Street Address |
905 ASSISI LN |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32233-2972 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821648577 | Danielle Woodring | Physical Therapist | 905 Assisi Ln, Jacksonville, FL 32233-2972 | 2019-09-16 |
| 1891340550 | Joseph Raymond Jumarang | Physical Therapist | 905 Assisi Ln, Jacksonville, FL 32233-2972 | 2019-08-08 |
| 1538728498 | Aquilla Lynette Cribb | Physical Therapist | 905 Assisi Ln, Jacksonville, FL 32233-2972 | 2019-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881223469 | Ethem Gokdeniz | Private Vehicle | 2274 Fairway Villas Ln North, Atlantic Beach, FL 32233 | 2020-04-06 |
| 1184181000 | Jeremy Klimek | Occupational Therapist | 910 Assisi Lane, Jacksonville, FL 32233 | 2019-02-27 |
| 1811344385 | Kacy Lane Kreger | Speech-Language Pathologist | 2753 Shangri La Dr, Jacksonville, FL 32233 | 2016-05-15 |
| 1407233489 | Meghan Braun | Physical Therapist | 2159 Featherwood Drive West, Atlantic Beach, FL 32233 | 2015-04-29 |
| 1184979908 | Hope and A Future Ministries, Inc. | Clinic/Center | 680 Mayport Rd., Atlantic Beach, FL 32233 | 2012-07-18 |
| 1003171588 | Cheryl M Thacker | Massage Therapist | 531 Atlantic Boulevard, Ste 7, Atlantic Beach, FL 32233 | 2012-07-10 |
| 1730465451 | Jeffery Kreck | Physical Therapy Assistant | 1401 Defender Court West, Atlantic Beach, FL 32233 | 2011-10-26 |
| 1992977029 | Jax Rx Inc | Durable Medical Equipment & Medical Supplies | 1174 Beach Ave, Atlantic Beach, FL 32233 | 2008-03-28 |
| 1336368059 | Lovell L. Farris | Dentist | 10 10th St, Unit 3a, Atlantic Beach, FL 32233 | 2007-04-24 |
| 1033284922 | Maureen C Baxter | Nurse Practitioner | 815 Plaza, Jacksonville, FL 32233 | 2006-11-24 |
| Find all providers in zip 32233 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902404668 | Tambolina Services Community Resident Home, Inc | Assisted Living Facility | 6285 Cranberry Ln W, Jacksonville, FL 32244-2559 | 2020-10-15 |
| 1316552284 | Enhanced Universal Care Alf | Assisted Living Facility | 10967 Key Haven Blvd, Jacksonville, FL 32218-4463 | 2020-09-08 |
| 1710527270 | Rosecastle of Jacksonville LLC | Assisted Living Facility | 8929 R G Skinner Pkwy, Jacksonville, FL 32256-9724 | 2020-01-13 |
| 1891353777 | V & K Horizons | Assisted Living Facility | 7019 Mark St, Jacksonville, FL 32210-4889 | 2019-06-05 |
| 1144784638 | Carole Stallworth | Assisted Living Facility | 5116 Mcmanus Dr, Jacksonville, FL 32210-6353 | 2019-01-29 |
| 1467921569 | Heart To Heart LLC | Assisted Living Facility | 9378 Arlignton Expressway, Ste 218, Jacksonville, FL 32225 | 2018-11-19 |
| 1073090437 | Lashonda Oglesby | Assisted Living Facility | 6313 Arlington Rd, Jacksonville, FL 32211-5423 | 2018-07-27 |
| 1831697218 | Cortney Irene Matthews | Assisted Living Facility | 3109 Gilmore St, Jacksonville, FL 32205-5516 | 2018-01-31 |
| 1831608975 | Silver Shores Living, Inc | Assisted Living Facility | 2317 Gilmore St, Jacksonville, FL 32204-3119 | 2017-09-20 |
| 1679092886 | Palm Life Medical Associates Pa | Assisted Living Facility | 12494 Acosta Oaks Drive, Jacksonville, FL 32258 | 2017-09-19 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32233 |
Please comment or provide details below to improve the information on ANTHEM LAKES.
| 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.