NPIMap

Organization Active NPI

Naval Continuing Care Retirement Foundation, Inc.

  • Home Health Agency
  • Atlantic Beach, FL
National Provider Identifier
1346649308
Registry record updated Aug 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
299992171 Issued in FL
Legal business name
NAVAL CONTINUING CARE RETIREMENT FOUNDATION, INC.
Practice address
1 Fleet Landing Blvd
Atlantic Beach, FL 32233-4599
Phone
(904) 246-9900
Fax
(904) 246-9566
NPI assigned
Aug 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2014

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

Authorized official

Name
Mrs. Elizabeth Sholar, NHA
Title
Sr. Director of Health Care Service
Phone
(904) 246-9900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 299992171 FL Primary

Addresses

Primary practice location

1 Fleet Landing Blvd
Atlantic Beach, FL 32233-4599

Mailing address

1 Fleet Landing Blvd
Atlantic Beach, FL 32233-4599
Phone (904) 246-9900

Other names 1

  • Fleet Landing Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150130000676 FL Part A Provider - Home Health Agency 0840371597 Practice locations: Atlantic Beach, FL

Home health agency certification: CCN 683193

Legal name
NAVAL CONTINUING CARE RETIREMENT FOUNDATION, INC
Doing business as
FLEET LANDING HOME HEALTH LLC
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Aug 26, 2015
Last certification
Jul 18, 2018
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1985 in FL
Enrollment address
1 Fleet Landing Blvd
Atlantic Beach, FL 32233-4599
HHA Branch

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Home health agency

Medicare Care Compare
Listed as
Fleet Landing Home CareCCN 683193
Overall star rating
3.5 of 5
Ownership
Non-Profit
Certified
Aug 26, 2015
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
Naval Continuing Care Retirement Foundation Inc2 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.

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
Cynthia Hack Individual Operational/Managerial ControlController Mar 1, 2012
Joshua Ashby Individual Corporate OfficerSecretary Dec 1, 2013 7.14%
Corporate DirectorDirector Dec 1, 2013 7.14%
Operational/Managerial ControlCeo Sep 1, 2010 100%
Polaris Endeavors, Inc. Organization, Atlantic Beach, FL Non-profit 5% Or Greater Direct Ownership Interest Apr 15, 2023 100%
Deborah R Gordon Individual Operational/Managerial ControlHome Health Administrator Mar 1, 2023

Owners & managing parties with NPI records 1

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Fleet LandingAtlantic Beach, FL, CCN 105743 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) Oct 2, 1991

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 1

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

Practitioners & affiliated clinicians

Affiliated clinicians 6

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": "1408060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408060800000",
    "number": "1346649308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FLEET LANDING BLVD",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322334599",
            "telephone_number": "904-246-9900",
            "fax_number": "904-246-9566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FLEET LANDING BLVD",
            "city": "ATLANTIC BEACH",
            "state": "FL",
            "postal_code": "322334599",
            "telephone_number": "904-246-9900",
            "fax_number": "904-246-9566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NAVAL CONTINUING CARE RETIREMENT FOUNDATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-15",
        "last_updated": "2014-08-15",
        "status": "A",
        "authorized_official_last_name": "SHOLAR",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "SR. DIRECTOR OF HEALTH CARE SERVICE",
        "authorized_official_telephone_number": "904-246-9900",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "299992171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fleet Landing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlantic Beach, FL

Sources for this page

Verify at the official NPI Registry.