St Catherine Laboure Manor Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1517096 Issued in FL

Legal business name

ST CATHERINE LABOURE MANOR INC

Practice address

1750 Stockton St
Jacksonville, FL 32204-4664

Phone

(904) 308-7300

NPI assigned

Sep 6, 2006

Organization subpart

No

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

Authorized official

Name

Scott Whalen

Title

Chief Executive Officer

Phone

(904) 308-8194

Specialties & licenses 1

Addresses

Other identifiers 3

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Orthopedic Reshabilitation Unit

  • Skilled Nursing Facility
  • Jacksonville, FL
  • NPI 1215228226
  NPPES parent name

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1316040280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 STOCKTON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044664",
            "telephone_number": "904-308-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 STOCKTON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322044664",
            "telephone_number": "904-308-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST CATHERINE LABOURE MANOR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "WHALEN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "904-308-8194"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "1517096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "K77",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020515000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME MAC",
            "identifier": "0804730001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sridhar Srinivasan, MD
• Archit Ajay Srivastava, M.B.B.S/MD
• SS Duval Community HC LLC (First Coast Health And Rehabilitation Center)
• SSS Healthcare Services, L.L.C.
• SSW Counseling, PLLC
• Claudette St Charles
• Jay St Charles II, DDS
• Kim St Clair Seals, ARNP-BC
• Jesse W St Clair IV, MD
• St Claire Counseling, LLC

• 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 May 12, 2009; 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.