NPIMap

Organization Active NPI

Sovereign Healthcare of Tuskawilla, LLC

Doing business as Tuskawilla Nursing & Rehab Center

  • Skilled Nursing Facility
  • Winter Springs, FL
National Provider Identifier
1346237963
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF1625096 Issued in FL
Legal business name
SOVEREIGN HEALTHCARE OF TUSKAWILLA, LLC
Doing business as
Tuskawilla Nursing & Rehab Center
Practice address
1024 Willa Springs Dr
Winter Springs, FL 32708-5214
Phone
(407) 699-5506
Fax
(407) 699-8269
NPI assigned
Sep 29, 2005
Last updated
Sep 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Authorized official

Name
Mr. R. Mark Cronquist
Title
Manager
Phone
(404) 574-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF1625096 FL Primary

Addresses

Primary practice location

1024 Willa Springs Dr
Winter Springs, FL 32708-5214

Mailing address

5887 Glenridge Dr
Suite 150
Atlanta, GA 30328-5574
Phone (404) 574-2100

Other identifiers 2

IdentifierTypeStateIssuer
V573P-6390OtherVA
026359100MedicaidFL

Other names 1

  • Tuskawilla Nursing & Rehab Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030903000021 FL Part A Provider - Skilled Nursing Facility 4880505122 Practice locations: Winter Springs, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346237963. Details of each certification follow.

Skilled nursing facility certification: CCN 105872

Legal name
SOVEREIGN HEALTHCARE OF TUSKAWILLA, LLC
Doing business as
TUSKAWILLA NURSING AND REHAB CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 7, 1994
Last certification
Jun 20, 2024
Beds
98
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Sovereign Health Care Managerment LLC
Most recent change of ownership
Oct 1, 2003
Organization structure
LLCProprietary
Enrollment address
1024 Willa Springs Dr
Winter Springs, FL 32708-5214
Nursing home name
TUSKAWILLA NURSING AND REHAB CENTER
Affiliated entity
SOVEREIGN HEALTHCARE HOLDINGS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Tuskawilla Nursing and Rehab CenterCCN 105872 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Nov 7, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9887.3 residents per day on average
Chain
Sovereign Healthcare Holdings43 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0892276Tuskawilla Nursing and Rehab Center1024 Willa Springs Drive, Winter Springs, FL 32708Certificate of waiverSep 26, 2026

National Provider Directory

National Provider Directory

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 19

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

NameRoleSinceShare
Susan Kaar Individual Managing Control - Governing BodyVice President of Compliance and QM Oct 1, 2003
Adp of the SNF Oct 1, 2003
Sovereign Healthcare Disbursements LLC Organization, Casselberry, FL LLC Adp of the SNF May 19, 2009
Henry Gerrity Individual Managing Control - Governing BodyVice President of Operations Apr 1, 2014
Adp of the SNF Apr 1, 2014
John Mangine Individual Operational/Managerial Control Jun 25, 2012
Adp of the SNF Jun 25, 2012
Indirect Ownership Interest Jun 25, 2012 3%
Southern Healthcare Management LLC Organization, Casselberry, FL LLC, Management services company, For-profit Operational/Managerial Control May 19, 2009
Adp of the SNF Oct 23, 2025
Akila Balasubramanian Individual Operational/Managerial Control Feb 28, 2018
Adp of the SNF Feb 28, 2018
Rodrick B Galvin Individual Operational/Managerial Control Oct 21, 2022
Adp of the SNF Oct 21, 2022
Michelle Kelly Individual Adp of the SNF Feb 1, 2018
Donald K Melton Individual Operational/Managerial Control Feb 15, 2009
Adp of the SNF Feb 15, 2009
William Notermann Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
FL Tuskawilla Holdings, LLC Organization, Miami, FL LLC, Owned by another organization or individual 5% Or Greater Security Interest May 19, 2009 100%
Adp of the SNF May 19, 2009
Sovereign Healthcare Holdings LLC Organization, Atlanta, GA LLC, Holding company, For-profit, Chain home office, Owned by another organization or individual Direct Ownership Interest Oct 1, 2003 100%
Berkadia Commercial Mortgage LLC Organization, Horsham, PA Financial institution 5% Or Greater Security Interest Sep 23, 2014 100%
Royce M Cronquist Individual Operational/Managerial Control Nov 12, 2017
Adp of the SNF Feb 1, 2018
John J Notermann Business TR Organization, Atlanta, GA For-profit Indirect Ownership Interest Nov 12, 2017 82.5%
Forvis Mazars LLP Organization, Springfield, MO Adp of the SNF Jan 1, 2025
Dawn Chery Individual Managing Control - Governing BodyChief Nursing Officer Jun 8, 2017
Adp of the SNF Jun 8, 2017
Health Services Properties LLC Organization, Casselberry, FL LLC, Owned by another organization or individual 5% Or Greater Security Interest May 19, 2009 100%
Adp of the SNF May 19, 2009
Cronquist 2015 Family TR Organization, Atlanta, GA For-profit Indirect Ownership Interest Dec 31, 2015 14.5%

Owners & managing parties with NPI records 1

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

Facilities with the same owner 41

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 41

Practitioners & affiliated clinicians

Affiliated clinicians 7

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

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1346237963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5887 GLENRIDGE DR",
            "address_2": "SUITE 150",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285574",
            "telephone_number": "404-574-2100",
            "fax_number": "404-574-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 WILLA SPRINGS DR",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327085214",
            "telephone_number": "407-699-5506",
            "fax_number": "407-699-8269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN HEALTHCARE OF TUSKAWILLA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "CRONQUIST",
        "authorized_official_first_name": "R.",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-574-2100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1625096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA",
            "identifier": "V573P-6390",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026359100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tuskawilla Nursing & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Winter Springs, FL

Sources for this page

Verify at the official NPI Registry.