NPIMap

Organization Active NPI

Alivia Care Solutions, Inc.

Doing business as Alivia Supportive Care

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Jacksonville, FL
National Provider Identifier
1043979453
Registry record updated Dec 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
ALIVIA CARE SOLUTIONS, INC.
Doing business as
Alivia Supportive Care
Practice address
4266 Sunbeam Rd FL 32257
Jacksonville, FL 32257-2425
Phone
(904) 268-5200
NPI assigned
Dec 13, 2021
Last updated
Dec 13, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
ALIVIA CARE SOLUTIONS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 13, 2021

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

Authorized official

Name
Susan Anne Ponder-Stansel
Title
President & Ceo
Phone
(904) 407-6362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RH0002X Primary

Addresses

Primary practice location

4266 Sunbeam Rd FL 32257
Jacksonville, FL 32257-2425

Mailing address

4266 Sunbeam Rd FL 32257
Jacksonville, FL 32257-2425
Phone (904) 268-5200

Other names 1

  • Alivia Supportive Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220302001251 FL Part B Supplier - Clinic/Group Practice 0648688044 Receives reassigned benefits from 16 practitioners
1 other NPI on this enrollment
Practice locations: Jacksonville, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Alivia Supportive Care5 organizations share this tax ID, including this one
Part of
Alivia Supportive Care

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1639353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639353600000",
    "number": "1043979453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4266 SUNBEAM RD FL 32257",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572425",
            "telephone_number": "904-268-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4266 SUNBEAM RD FL 32257",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572425",
            "telephone_number": "904-268-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALIVIA CARE SOLUTIONS, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALIVIA CARE SOLUTIONS, INC.",
        "enumeration_date": "2021-12-13",
        "last_updated": "2021-12-13",
        "certification_date": "2021-12-13",
        "status": "A",
        "authorized_official_last_name": "PONDER-STANSEL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "904-407-6362"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alivia Supportive Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.