HCR Manor Care Services of Florida, LLC

Primary specialty

Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X

Legal business name

HCR MANOR CARE SERVICES OF FLORIDA, LLC

Practice address

8130 Baymeadows Way W Ste 201
Jacksonville, FL 32256-7451

Phone

(904) 737-2553

NPI assigned

Apr 19, 2022

Organization subpart

No

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

Authorized official

Name

Martin David Allen

Title

Sole Director

Phone

(419) 252-5734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• ProMedica Hospice (Jacksonville) Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

All disclosed owners & managing parties 14

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650326400000",
    "number": "1154064848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10086",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436990086",
            "telephone_number": "567-585-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8130 BAYMEADOWS WAY W STE 201",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322567451",
            "telephone_number": "904-737-2553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HCR MANOR CARE SERVICES OF FLORIDA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "SOLE DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001418-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ProMedica Hospice (Jacksonville)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tanya Haywood
• Anne Hazen, APRN
• Hazouri Adjustable Beds, Inc.
• HCC Healthcare Consultants Inc
• HCM Wellness LLC
• HCR Manor Care Services of Florida, LLC
• HDX Labs LLC
• Xuemei He, FNP
• Sonya Nicole Head, ARNP
• Deborah Ann Headley, PT

• Hospice and Palliative Medicine (Internal Medicine) Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Hospice and Palliative Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.