650 Reed Canal Road Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1122096 Issued in FL

Legal business name

650 REED CANAL ROAD OPERATIONS LLC

Doing business as

Oaktree Healthcare

Practice address

650 Reed Canal Rd
South Daytona, FL 32119-3230

Phone

(386) 767-4831

Fax

(386) 767-8253

NPI assigned

Dec 27, 2011

Last updated

Nov 27, 2023By 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

Kenneth Ussery

Title

VP

Phone

(407) 571-1550

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Oaktree Healthcare Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1336418086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 REED CANAL RD",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193230",
            "telephone_number": "386-767-4831",
            "fax_number": "386-767-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 REED CANAL RD",
            "city": "SOUTH DAYTONA",
            "state": "FL",
            "postal_code": "321193230",
            "telephone_number": "386-767-4831",
            "fax_number": "386-767-8253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "650 REED CANAL ROAD OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-27",
        "last_updated": "2023-11-27",
        "certification_date": "2020-05-15",
        "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": "SNF1122096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004384300",
            "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": "Oaktree Healthcare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Oaktree Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 24/7 Medical LLC
• Ability Health Services and Rehabilitation LP
• Ability Health Services, Inc
• Absolute Health Professionals Inc.
• Accdient & Injury Center Inc
• Jacolby Patrice Adams

• Skilled Nursing Facility in South Daytona, FL
• Providers in South Daytona, 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.