NPIMap

Organization Active NPI

Florida Department of Veterans Affairs

Doing business as Emory L Bennett State Veterans Nursing Home

  • Skilled Nursing Facility
  • Daytona Beach, FL
National Provider Identifier
1174515654
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF1143095 Issued in FL
Legal business name
FLORIDA DEPARTMENT OF VETERANS AFFAIRS
Practice address
1920 Mason Ave
Daytona Beach, FL 32117-5103
Phone
(386) 274-3460
Fax
(386) 274-3487
NPI assigned
Aug 19, 2005
Last updated
Jul 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Authorized official

Name
Miss Claudia Renee Day
Title
Program Director
Phone
(727) 518-3202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF1143095 FL Primary

Addresses

Primary practice location

1920 Mason Ave
Daytona Beach, FL 32117-5103

Mailing address

1920 Mason Ave
Daytona Beach, FL 32117-5103
Phone (386) 274-3460

Other identifiers 1

IdentifierTypeStateIssuer
021088900MedicaidFL

Other names 1

  • Emory L Bennett State Veterans Nursing Home Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081112000493 FL Part A Provider - Skilled Nursing Facility 5698686608 Practice locations: Daytona Beach, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174515654. Details of each certification follow.

Skilled nursing facility certification: CCN 105840

Legal name
FLORIDA DEPARTMENT OF VETERANS AFFAIRS
Doing business as
EMORY L. BENNETT STATE VETERANS' NURSING HOME
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 19, 1994
Last certification
Oct 17, 2024
Beds
120
Ownership / control type
State
Multi-facility organization
Florida Department of Veterans Affairs
Organization structure
GovernmentProprietary
Incorporated
Jan 1, 1990 in FL
Enrollment address
1920 Mason Ave
Emory L. Bennett Memorial State Veterans' Nursing
Daytona Beach, FL 32117-5103
Nursing home name
EMORY L BENNETT MEMORIAL VETERANS NURSING HOME
Affiliated entity
FLORIDA DEPARTMENT OF VETERANS' AFFAIRS

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Emory L Bennett Memorial Veterans Nursing HomeCCN 105840 · All quality measures
Overall star rating
4 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
Government - State
Certified
Jan 19, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120115.1 residents per day on average
Chain
Florida Department of Veterans' Affairs7 facilities in the chain
Penalties (3 years)
1Fines totaling $9,503

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Sunland Center Marianna15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Paula S Twitty Individual Corporate DirectorAdministrator Jun 15, 2023
Adp of the SNF Mar 21, 2025
Kelli Champagne Individual Operational/Managerial Control Feb 1, 2023
Florida Department of Veterans Affairs Organization, Daytona Beach, FL Medical provider/supplier 5% Or Greater Direct Ownership Interest Nov 18, 2014 100%
Sandford H Kinne Individual Adp of the SNF Mar 21, 2025
Alfred Carter Individual Corporate Director Jul 1, 2010

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Clyde E Lassen State Veterans Nursing HomeSt Augustine, FL, CCN 106088 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Sep 1, 2010
Douglas Jacobson State Veterans' Nursing HomePort Charlotte, FL, CCN 106059 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Apr 1, 2004
Clifford Chester Sims State Veterans' Nursing HomePanama City, FL, CCN 106056 Skilled nursing facility Direct Ownership Interest (100%) Aug 1, 2003
Baldermo Lopez State Veterans' Nursing HomeLand O Lakes, FL, CCN 106006 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1999
Florida Department of Veterans AffairsPort St Lucie, FL, CCN 686128 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 30, 2022
Florida Department of Veterans AffairsOrlando, FL, CCN 106151 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Jun 1, 2023

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1174515654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 MASON AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175103",
            "telephone_number": "386-274-3460",
            "fax_number": "386-274-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 MASON AVE",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175103",
            "telephone_number": "386-274-3460",
            "fax_number": "386-274-3487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DEPARTMENT OF VETERANS AFFAIRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-19",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "DAY",
        "authorized_official_first_name": "CLAUDIA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "727-518-3202",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1143095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021088900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emory L Bennett State Veterans Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Emory L Bennett State Veterans Nursing Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Daytona Beach, FL

Sources for this page

Verify at the official NPI Registry.