CCRC OPCO - CYPRESS VILLAGE, LLC (NPI# 1760431399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760431399 |
| Entity Type | Organization |
| Organization Name | CCRC OPCO - CYPRESS VILLAGE, LLC |
| Other Organization Name | CYPRESS VILLAGE |
| Practice Address |
4600 Middleton Park Cir E Jacksonville FL 32224-5691 |
| Mailing Address |
330 N Wabash Ave Suite 1400 Chicago IL 60611-3586 |
| Practice Telephone | 9012236100 |
| Mailing Telephone | 3129773700 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2014-10-03 |
| Authorized Official Name | MR. MARK W OHLENDORF (PRESIDENT) |
| Authorized Official Telephone | 4149185000 |
| Is Organization Subpart | Y |
| Parent Organization Name | BROOKDALE SENIOR LIVING INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | AL7720 | FL | Nursing & Custodial Care Facilities |
| Y | 314000000X | Skilled Nursing Facility | SNF11170961 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 30799800 | 05 |
| Other Name | Type Code |
|---|---|
| Cypress Village | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790199057 | Ccrc Opco - Cypress Village, LLC | Skilled Nursing Facility | 4600 Middleton Park Cir E, Jacksonville, FL 32224-5691 | 2014-06-16 |
| Street Address |
4600 MIDDLETON PARK CIR E |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32224-5691 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144610627 | Jason Cummings | Physical Therapy Assistant | 4600 Middleton Park Cir E, Jacksonville, FL 32224-5691 | 2015-02-04 |
| 1790199057 | Ccrc Opco - Cypress Village, LLC | Skilled Nursing Facility | 4600 Middleton Park Cir E, Jacksonville, FL 32224-5691 | 2014-06-16 |
| 1720137870 | Arc Therapy Services LLC | Clinic/Center | 4600 Middleton Park Cir E, Jacksonville, FL 32224-5691 | 2007-01-09 |
| 1720030950 | Vanessa Z Riegert-johnson | Internal Medicine | 4600 Middleton Park Cir E, D-250, Jacksonville, FL 32224-5691 | 2006-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356974372 | Noelle Parker | Specialist/Technologist | 1 Unf Drivve, Jacksonville, FL 32224 | 2020-02-18 |
| 1124685102 | Charcy Rene Stiller | Specialist/Technologist | 1 Unf Dr., Jacksonville, FL 32224 | 2019-05-24 |
| 1265097513 | Mayo Clinic Jacksonville | Ambulance | 13970 Zumbro Dr, Jacksonville, FL 32224 | 2019-05-02 |
| 1639681471 | Brigantti Anesthesia & Spine Care | Clinic/Center | 1361 13th Ave South Suite #210, Jacksonville, FL 32224 | 2017-11-02 |
| 1093240061 | Beric Emilio Berlioz | Anesthesiology | 4500 San Pablo Rd S # J, Jacksonville, FL 32224 | 2017-04-26 |
| 1609240746 | Matthew James Dailey | Nurse Anesthetist, Certified Registered | 2500 San Pablo Rd S, Jacksonville, FL 32224 | 2015-11-29 |
| 1003299603 | Upscale Personal Care Home | Assisted Living Facility | 4375 Autumn River Road, Jacksonville, FL 32224 | 2015-07-01 |
| 1629459375 | Bellanid Fonseca | Social Worker | 3694 Summerlin Ln E, Jacksonville, FL 32224 | 2015-06-17 |
| 1164840500 | Nicholas Scotto | Physical Therapist | 11555 Central Pkwy Ste 1104, Jacksonville, FL 32224 | 2014-04-02 |
| 1497093454 | Quicker Care Urgent Care | Point of Service | 13770 Beach Blvd., Unit # 4, Jacksonville, FL 32224 | 2013-01-27 |
| Find all providers in zip 32224 | ||||
| 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 | 32224 |
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| 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.