NPIMap

Organization Active NPI

Villa Maria Nursing & Rehabilitation Center

  • Skilled Nursing Facility
  • North Miami, FL
National Provider Identifier
1386625036
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF1576096 Issued in FL
Legal business name
VILLA MARIA NURSING & REHABILITATION CENTER
Practice address
1050 NE 125TH St
North Miami, FL 33161-5805
Phone
(305) 891-8850
Fax
(305) 891-3361
NPI assigned
Nov 9, 2005
Last updated
Jan 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

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

Authorized official

Name
Mr. Nathaniel Johnson, NHA
Title
Executive Director
Phone
(305) 891-8850

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF1576096 FL Primary

Addresses

Primary practice location

1050 NE 125TH St
North Miami, FL 33161-5805

Mailing address

1050 NE 125TH St
North Miami, FL 33161-5805
Phone (305) 891-8850

Other identifiers 2

IdentifierTypeStateIssuer
120022MedicaidFL
203165MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111014000111 FL Part A Provider - Skilled Nursing Facility 2860483294 Practice locations: North Miami, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1386625036. Details of each certification follow.

Skilled nursing facility certification: CCN 105232

Legal name
VILLA MARIA NURSING & REHABILITATION CENTER
Doing business as
VILLA MARIA NURSING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
May 27, 1970
Last certification
Mar 15, 2024
Beds
212
Ownership / control type
Nonprofit Corporation
Organization structure
OtherNon-profit
Incorporated
Feb 18, 1966 in FL
Enrollment address
1050 NE 125TH Street
Villa Maria Nursing Center
North Miami, FL 33161-5805
Nursing home name
VILLA MARIA NURSING CENTER

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Villa Maria Nursing CenterCCN 105232 · All quality measures
Overall star rating
2 of 5
Health inspections
1 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
May 27, 1970
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
212184.5 residents per day on average
Abuse citation
Cited for abuse (Care Compare abuse icon)
Penalties (3 years)
2Fines totaling $161,110

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
Villa Maria Nursing Rehabilitation Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Networks

  • HealthSun Health Plans Network

Ownership & related parties

All disclosed owners & managing parties 6

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

NameRoleSinceShare
Laura Wilson Individual Operational/Managerial Control Jan 1, 2024
Archdiocese of Miami Inc Organization, Miami Shores, FL 5% Or Greater Indirect Ownership Interest Jan 31, 1995 100%
Villa Maria Nursing & Rehabilitation Center Organization, North Miami, FL 5% Or Greater Direct Ownership Interest Jan 31, 1995 100%
Mary Frick Individual Corporate OfficerPresident & Ceo Apr 1, 2024
Nathaniel Johnson Individual Operational/Managerial Control Jan 1, 2017
Adp of the SNF Feb 13, 2025
Hamidreza Moghaddam Individual Operational/Managerial Control Jan 1, 2024
Adp of the SNF Jul 16, 2025

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 2

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

FacilityTypeRoleSince
St Catherine's Rehabilitation HospitalNorth Miami, FL, CCN 103026 Hospital 5% Or Greater Direct Ownership Interest (100%) Feb 18, 1966
Villa Maria West Skilled Nursing FacilityHialeah Gardens, FL, CCN 106080 Skilled nursing facility 5% Or Greater Direct Ownership Interest (100%) May 1, 2009

Owned or controlled facilities with NPI records 2

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

Facilities with the same owner 7

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

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": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580342400000",
    "number": "1386625036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 NE 125TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615805",
            "telephone_number": "305-891-8850",
            "fax_number": "305-891-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 NE 125TH ST",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615805",
            "telephone_number": "305-891-8850",
            "fax_number": "305-891-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLA MARIA NURSING & REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "305-891-8850",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1576096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120022",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "203165",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Miami, FL

Sources for this page

Verify at the official NPI Registry.