NPIMap

Organization Active NPI

John Knox Village of Central Florida, Inc

  • Home Health Agency
  • Orange City, FL
National Provider Identifier
1346584828
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
20602096 Issued in FL
Legal business name
JOHN KNOX VILLAGE OF CENTRAL FLORIDA, INC
Practice address
101 Northlake Dr
Orange City, FL 32763-6167
Phone
(386) 775-3840
Fax
(386) 775-0456
NPI assigned
Nov 21, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Authorized official

Name
Joseph Trainor
Title
Executive Director
Phone
(386) 775-3840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 20602096 FL Primary

Addresses

Primary practice location

101 Northlake Dr
Orange City, FL 32763-6167

Mailing address

101 Northlake Dr
Orange City, FL 32763-6167
Phone (386) 775-3840

Other names 1

  • John Knox Village of Central Florida Home Health Agency Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090701000605 FL Part A Provider - Home Health Agency 4284785205 1 other NPI on this enrollment
Practice locations: Orange City, FL

Home health agency certification: CCN 107530

Legal name
JOHN KNOX VILLAGE OF CENTRAL FLORIDA INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
May 16, 1996
Last certification
Feb 5, 2020
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Enrollment address
101 Northlake Dr
Orange City, FL 32763-6167

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Home health agency

Medicare Care Compare
Listed as
John Knox Village of Central Florida IncCCN 107530
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
May 16, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Oak Park Clinic4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Networks

  • 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)
  • 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 Maximo (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)…

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Joe Trainor Individual Corporate OfficerChief Administrative Officer Oct 27, 2015
Operational/Managerial ControlChief Administrative Officer Oct 27, 2015
John Knox Village of Central Florida Inc. Organization, Orange City, FL Corporation, Non-profit 5% Or Greater Direct Ownership Interest May 16, 1996 100%
Operational/Managerial Control Jan 1, 2015
Cynthia Pohl Individual Corporate OfficerChief Financial Officer Feb 21, 2022
W-2 Managing EmployeeChief Financial Officer Feb 21, 2022
Nicole Vega Individual W-2 Managing EmployeeDirector of Clinical Services Dec 31, 2021

Owners & managing parties with NPI records 3

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

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1353456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470614400000",
    "number": "1346584828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NORTHLAKE DR",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327636167",
            "telephone_number": "386-775-3840",
            "fax_number": "386-775-0456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NORTHLAKE DR",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327636167",
            "telephone_number": "386-775-3840",
            "fax_number": "386-775-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN KNOX VILLAGE OF CENTRAL FLORIDA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-21",
        "last_updated": "2016-08-08",
        "status": "A",
        "authorized_official_last_name": "TRAINOR",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "386-775-3840"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "20602096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John Knox Village of Central Florida Home Health Agency",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.