Southpoint Drive East Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SOUTHPOINT DRIVE EAST OPCO LLC

Doing business as

Aviata at Jacksonville

Practice address

4101 Southpoint Dr E
Jacksonville, FL 32216-0996

Phone

(904) 296-6800

Fax

(904) 296-1398

NPI assigned

Jul 14, 2023

Last updated

Apr 9, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nathan Freund

Title

Manager

Phone

(732) 730-7480

Specialties & licenses 1

Addresses

Other names 1

• Aviata at Jacksonville Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255010427. Details of each certification follow.

• CCN 105917 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 105917

Legal name

SOUTHPOINT DRIVE EAST OPCO LLC

Doing business as

AVIATA AT JACKSONVILLE

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Aug 9, 1996

Last certification

Dec 13, 2023

Beds

116

Ownership / control type

Corporation

Multi-facility organization

Aviata Health Group

Organization structure

LLCProprietary

Incorporated

Jul 5, 2023 in FL

Enrollment address

4101 Southpoint Dr E
Jacksonville, FL 32216-0996

Nursing home name

AVIATA AT JACKSONVILLE

Affiliated entity

AVIATA HEALTH GROUP

Listed as

Aviata at JacksonvilleCCN 105917 · All quality measures

Overall star rating

3 of 5

Health inspections

3 of 5

Staffing

3 of 5

Quality measures

3 of 5

Type

Medicare and Medicaid

Ownership

For profit - Corporation

Certified

Aug 9, 1996

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

116109.7 residents per day on average

Chain

Aviata Health Group50 facilities in the chain

Penalties (3 years)

1Fines totaling $4,778

Processed by Care Compare on Aug 1, 2026.

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 9

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

Owners & managing parties with NPI records 1

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

• George Yazji, MD

  • Hospitalist Physician
  • Gainesville, FL
  • NPI 1417417924

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 3

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

• Samira Khazravan, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Jacksonville, FL
  • NPI 1942494984

  Nursing home

  Care Compare affiliation
• Maninder Sethi, MD

  • Hospitalist Physician
  • Jacksonville, FL
  • NPI 1710477377

  Nursing home

  Care Compare affiliation
• George Yazji, MD

  • Hospitalist Physician
  • Gainesville, FL
  • NPI 1417417924

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744156800000",
    "number": "1255010427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 SOUTHPOINT DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160996",
            "telephone_number": "904-296-6800",
            "fax_number": "904-296-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 SOUTHPOINT DR E",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322160996",
            "telephone_number": "904-296-6800",
            "fax_number": "904-296-1398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHPOINT DRIVE EAST OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-14",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A",
        "authorized_official_last_name": "FREUND",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-730-7480"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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",
            "affiliationName": "Consulate Health Care",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "850 Concourse Pkwy S Ste 250",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Aviata at Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Jacksonville, FL
• Providers in Jacksonville, 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 Apr 9, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.