INDIAN RIVER CENTER, LLC (NPI# 1164410197) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164410197 |
| Entity Type | Organization |
| Organization Name | INDIAN RIVER CENTER, LLC |
| Other Organization Name | INDIAN RIVER CENTER |
| Practice Address |
7201 Greenboro Dr West Melbourne FL 32904-1698 |
| Practice Telephone | 3217270990 |
| Practice Fax Number | 3219514553 |
| Mailing Telephone | 3217270990 |
| Mailing Fax Number | 3219514553 |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2013-02-13 |
| Authorized Official Name | MRS. JENNIFER ALISE ZIOLKOWSKI (VP FINANCE) |
| Authorized Official Telephone | 8135586629 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | SNF1348096 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | AETNA | 0005900226 | 01 |
| FL | 026066500 | 05 | |
| MI | BLUE CROSS BLUE SHIELD MI | 08845 | 01 |
| FL | EVERCARE HH CONNECTION | 70-00474 | 01 |
| FL | UNITED AMERICAN | C105673 | 01 |
| FL | BLUE CROSS BLUE SHIELD | K3M | 01 |
| Other Name | Type Code |
|---|---|
| Indian River Center | Doing Business As Name - Organization |
| Street Address |
7201 GREENBORO DR |
| City | WEST MELBOURNE |
| State | FL |
| Zip Code | 32904-1698 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598055352 | Melanie Ann Lambert | Contractor | 7201 Greenboro Dr, West Melbourne, FL 32904-1698 | 2011-04-13 |
| 1437384641 | Kristen Marie Brong | Occupational Therapist | 7201 Greenboro Dr, West Melbourne, FL 32904-1698 | 2009-05-18 |
| 1972737955 | Tammy Lee Farrell | Physical Therapy Assistant | 7201 Greenboro Dr, West Melbourne, FL 32904-1698 | 2009-05-06 |
| 1619119229 | Dianna Linda Apostol Puchero | Occupational Therapist | 7201 Greenboro Dr, West Melbourne, FL 32904-1698 | 2009-03-27 |
| 1639314156 | Molly Kathryn Johnson | Speech-Language Pathologist | 7201 Greenboro Dr, West Melbourne, FL 32904-1698 | 2008-12-12 |
| 1417102724 | Jenevieve Serilo Oquendo | Physical Therapist | 7201 Greenboro Dr, West Melbourne, FL 32904-1698 | 2008-12-01 |
| 1043465479 | Joy Debusk | Skilled Nursing Facility | 7201 Greenboro Dr, West Melbourne, FL 32904-1698 | 2008-11-26 |
| 1063534485 | Sydney Kroeckcaddy | Speech-Language Pathologist | 7201 Greenboro Dr, West Melbourne, FL 32904-1698 | 2007-04-05 |
| 1063539419 | Michelle Anne Travis | Occupational Therapist | 7201 Greenboro Dr, West Melbourne, FL 32904-1698 | 2007-03-23 |
| 1962527135 | April Boltiador Reyes | Physical Therapist | 7201 Greenboro Dr, West Melbourne, FL 32904-1698 | 2007-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063066512 | Shepherd's Heart Ministries | Counselor | 900 S Wickham Rd, Melbourne, FL 32904 | 2019-08-01 |
| 1588138663 | Nicholle C Rothengass | Physician Assistant | 2263 W New Haven Ave # 350, W Melbourne, FL 32904 | 2019-01-11 |
| 1114407020 | Natalie Havkin | Speech-Language Pathologist | 250 S Wickham Rd., Melbourne, FL 32904 | 2018-08-20 |
| 1184119299 | Marni B Simon | Speech-Language Pathologist | 565 Acacia Ave, Melbourne Village, FL 32904 | 2018-06-30 |
| 1821588625 | Walden Psychological Services, LLC | Psychologist | 3400 Willowwood Dr, Melbourne, FL 32904 | 2018-05-16 |
| 1598276271 | Donetta Gwin Reynolds | Early Intervention Provider Agency | 764 Triples Crown Lane, West Melbourne, FL 32904 | 2017-10-20 |
| 1598205221 | Marathon Health, LLC | General Practice | 2550 Wingate Boulevard, C/o Brevard Wellcare- South, West Melbourne, FL 32904 | 2017-02-28 |
| 1366875387 | Cancer Center of Melbourne LLC | Clinic/Center | 415 S. Wickham Rd., Melbourne, FL 32904 | 2013-08-13 |
| 1558704312 | Sandra Suzanne Borthwick | Social Worker | 569 Sylvia Rd, Melbourne, FL 32904 | 2013-04-11 |
| 1396983607 | Genesis | Skilled Nursing Facility | 2653 Reflections Pl, W. Melbourne, FL 32904 | 2009-01-23 |
| Find all providers in zip 32904 | ||||
| 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 |
|---|---|---|---|---|
| 1407801186 | Northport Health Services of Florida, LLC | Skilled Nursing Facility | 2125 W New Haven Ave, West Melbourne, FL 32904-3803 | 2006-05-23 |
| 1043465479 | Joy Debusk | Skilled Nursing Facility | 7201 Greenboro Dr, West Melbourne, FL 32904-1698 | 2008-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306444708 | Center for Comprehensive Services, Inc. | Skilled Nursing Facility | 2411 Clement Rd, Lutz, FL 33549-5552 | 2020-10-16 |
| 1114530227 | Jupiter Rehab and Health Center LLC | Skilled Nursing Facility | 650 Pioneer Rd # 5, Jupiter, FL 33458-8834 | 2020-08-28 |
| 1821601089 | Wellington Rehab and Health Center, LLC | Skilled Nursing Facility | 10330 Nu Vista Ave, Wellington, FL 33414 | 2020-08-27 |
| 1043822349 | Oaks of Kissimmee Operations LLC | Skilled Nursing Facility | 320 N. Mitchell St, Kissimmee, FL 34741-4447 | 2020-08-18 |
| 1720690027 | Brynwood Operations LLC | Skilled Nursing Facility | 1656 S Jefferson St, Monticello, FL 32344-1652 | 2020-08-18 |
| 1326668120 | Key West Nursing Home Propco LLC | Skilled Nursing Facility | 5860 College Road, Key West, FL 33040 | 2020-04-21 |
| 1740800655 | Javara Troupe | Skilled Nursing Facility | 10043 Victory Gallop Loop, Ruskin, FL 33573-6744 | 2020-04-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1053944116 | Pruitthealth - Southwood, LLC | Skilled Nursing Facility | 2301 Bluff Oak Way, Tallahassee, FL 32311-6161 | 2020-02-18 |
| 1992336895 | Dolphin Pointe Health Care, LLC | Skilled Nursing Facility | 5355 Dolphin Point Rd., Jacksonville, FL 32211 | 2020-01-29 |
| Find all providers with the same taxonomy | ||||
| City | WEST MELBOURNE |
| Zip Code | 32904 |
Please comment or provide details below to improve the information on INDIAN RIVER CENTER, 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.