Oak Terrace Health Care Associates LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1181096 Issued in FL

Legal business name

OAK TERRACE HEALTH CARE ASSOCIATES LLC

Doing business as

Governor's Creek Health and Rehabilitation

Practice address

803 Oak St
Green Cove Springs, FL 32043-4317

Phone

(904) 284-5606

Fax

(904) 284-0392

NPI assigned

May 23, 2006

Organization subpart

No

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

Authorized official

Name

Linda F. Howard

Title

Manager

Phone

(904) 284-5606

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Governor's Creek Health and Rehabilitation Doing business as

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343865600000",
    "number": "1124073622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 OAK ST",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320434317",
            "telephone_number": "904-284-5606",
            "fax_number": "904-284-0392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "803 OAK ST",
            "city": "GREEN COVE SPRINGS",
            "state": "FL",
            "postal_code": "320434317",
            "telephone_number": "904-284-5606",
            "fax_number": "904-284-0392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK TERRACE HEALTH CARE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2012-08-02",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "904-284-5606"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1181096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025238700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Governor's Creek Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scott Allen Nelson, PA
• Diem-Phuc Tran Nguyen, MD
• Truc Grace Phuong Nguyen, PHARMD.
• Rachel Nieves, RN, IBCLC
• Oak Street Opco LLC (Aviata at Green Cove Springs)
• Breonna Oxendine, RPH
• Karen Patterson
• Estrella Jane A. Pena, PT
• Ashley F Perez
• Ryan Ciro Perretti

• Skilled Nursing Facility in Green Cove Springs, FL
• Providers in Green Cove Springs, 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 2, 2012; 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.