Southwood Nursing Center

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

SNF1508095 Issued in FL

Legal business name

SOUTHWOOD NURSING CENTER

Practice address

40 Acme St
Jacksonville, FL 32211-7953

Phone

(904) 724-5933

Fax

(904) 721-1274

NPI assigned

Oct 4, 2005

Last updated

Aug 22, 2020By 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

Mr. Terry Keith Carpenter

Title

Administrator

Phone

(904) 724-5933

Specialties & licenses 1

Addresses

Tax ID family

Riverwood Nursing Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Riverwood Nursing Center LLC

  • Skilled Nursing Facility
  • Jacksonville, FL
  • NPI 1891797874
  NPD tax ID

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255328399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 ACME ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322117953",
            "telephone_number": "904-724-5933",
            "fax_number": "904-721-1274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 ACME ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322117953",
            "telephone_number": "904-724-5933",
            "fax_number": "904-721-1274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWOOD NURSING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "KEITH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-724-5933",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "FL",
            "license": "SNF1508095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Nursing Facility/Intermediate Care Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Nursing Facility/Intermediate Care Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.