Organization Active NPI

Park Ridge Nursing & Rehab Center LLC

  • Skilled Nursing Facility
  • Jacksonville, FL
National Provider Identifier
1114880044
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
PARK RIDGE NURSING & REHAB CENTER LLC
Practice address
730 College St
Jacksonville, FL 32204-3313
Phone
(270) 594-8700
NPI assigned
Dec 8, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Authorized official

Name
Moshe Kelman
Title
Member
Phone
(917) 613-1662

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

730 College St
Jacksonville, FL 32204-3313

Mailing address

730 College St
Jacksonville, FL 32204-3313

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1765152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765152000000",
    "number": "1114880044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 COLLEGE ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 COLLEGE ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043313",
            "telephone_number": "270-594-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK RIDGE NURSING & REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-08",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A",
        "authorized_official_last_name": "KELMAN",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "917-613-1662"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 8, 2025; 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.