2826 Cleveland Avenue Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1290096 Issued in FL

Legal business name

2826 CLEVELAND AVENUE OPERATIONS LLC

Practice address

2826 Cleveland Ave
Fort Myers, FL 33901-6001

Phone

(239) 334-1091

Fax

(239) 334-9839

NPI assigned

Dec 29, 2011

Organization subpart

No

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

Authorized official

Name

Kenneth Ussery

Title

VP

Phone

(407) 571-1550

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heritage Park Rehabilitation and Healthcare Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1184993693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2826 CLEVELAND AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339016001",
            "telephone_number": "239-334-1091",
            "fax_number": "239-334-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2826 CLEVELAND AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339016001",
            "telephone_number": "239-334-1091",
            "fax_number": "239-334-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "2826 CLEVELAND AVENUE OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-29",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-28",
        "status": "A",
        "authorized_official_last_name": "USSERY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "407-571-1550"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1290096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006109500",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "800 Concourse Pkwy S Ste 200",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Heritage Park Rehabilitation and Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Heritage Park Rehabilitation and Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 21St Century Oncology LLC
• 21St Century Oncology LLC
• 21St Century Oncology LLC
• 21St Century Oncology LLC
• 21St Century Oncology LLC
• 360 Medical Centers LLC
• 360 Pharmacy & DME LLC
• 3735 Evans Avenue Operations LLC
• 3D Womens Health
• 4 Sisters 1 Brother Enterprises LLC

• Skilled Nursing Facility in Fort Myers, FL
• Providers in Fort Myers, 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 Nov 27, 2023; 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.