NPIMap

Organization Active NPI

PMR Virginia Holding, LLC

Doing business as Jencare Senior Medical Centers of Virginia

  • Specialist
  • Miami Gardens, FL
National Provider Identifier
1083167001
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
PMR VIRGINIA HOLDING, LLC
Doing business as
Jencare Senior Medical Centers of Virginia
Practice address
1395 NW 167TH St
Miami Gardens, FL 33169-5742
Phone
(305) 628-6117
NPI assigned
Jul 26, 2016
Last updated
Apr 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Authorized official

Name
Mary Chen
Title
Authorized Official
Phone
(786) 618-7245

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

1395 NW 167TH St
Miami Gardens, FL 33169-5742

Mailing address

1395 NW 167TH St
Miami Gardens, FL 33169-5742
Phone (305) 831-4760

Other names 1

  • JENCARE SENIOR MEDICAL CENTERS OF VIRGINIA Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210408000505 VA Part B Supplier - Clinic/Group Practice 9537576608 Receives reassigned benefits from 104 practitioners
Practice locations: Virginia Beach, VA; Richmond, VA; Newport News, VA; Portsmouth, VA; Norfolk, VA; Hampton, VA; Colonial Heights, VA

National Provider Directory

National Provider Directory
Tax ID family
Jencare Senior Medical Centers of Virginia2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

524 Southpark Blvd
Colonial Hgts, VA 23834
Phone (804) 504-7980

48 Newmarket Sq
Newport News, VA 23605
Phone (757) 825-8030

3960 Turnpike Rd
#A
Portsmouth, VA 23701

4106 Portsmouth Blvd
Portsmouth, VA 23701
Phone (757) 391-2850

6530 Hull St Rd
Richmond, VA 23224
Phone (804) 674-3425

6550 Hull St Rd
Richmond, VA 23224
Phone (804) 674-3425

Practitioners & affiliated clinicians

Practitioners 196

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 196

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1083167001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695742",
            "telephone_number": "305-831-4760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 NW 167TH ST",
            "city": "MIAMI GARDENS",
            "state": "FL",
            "postal_code": "331695742",
            "telephone_number": "305-628-6117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PMR VIRGINIA HOLDING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-26",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "786-618-7245"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JENCARE SENIOR MEDICAL CENTERS OF VIRGINIA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Miami Gardens, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.