The Fannie E. Taylor Home for the Aged, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1149095 Issued in FL

Legal business name

THE FANNIE E. TAYLOR HOME FOR THE AGED, INC.

Doing business as

Taylor Home

Practice address

3937 Spring Park Rd
Jacksonville, FL 32207-5739

Phone

(904) 636-0313

Fax

(904) 367-0021

NPI assigned

Feb 2, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mathew Sherburne

Title

V.P. Finance & Administration

Phone

(904) 636-0313

Specialties & licenses 1

Addresses

Other names 1

• Taylor Home Doing business as

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083752885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 CHESTER AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172252",
            "telephone_number": "904-636-0313",
            "fax_number": "904-367-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3937 SPRING PARK RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075739",
            "telephone_number": "904-636-0313",
            "fax_number": "904-367-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FANNIE E. TAYLOR HOME FOR THE AGED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHERBURNE",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "V.P. FINANCE & ADMINISTRATION",
        "authorized_official_telephone_number": "904-636-0313",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1149095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Taylor Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.