NPIMap

Organization Active NPI

The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1386658615
Registry record updated Oct 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
THE NEMOURS FOUNDATION
Practice address
10140 Centurion Pkwy N
The Nemours Foundation
Jacksonville, FL 32256-0532
Phone
(904) 697-5628
Fax
(907) 697-5629
NPI assigned
Jul 29, 2006
Last updated
Oct 29, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2012

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

Authorized official

Name
Mr. Rodney A McKendree
Title
VP, Finance
Phone
(904) 697-5628

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
Genetics Clinic/Center 261QG0250X
Hearing and Speech Clinic/Center 261QH0700X
Adolescent and Children Mental Health Clinic/Center 261QM0855X
Multi-Specialty Clinic/Center 261QM1300X Primary
Medical Specialty Clinic/Center 261QM2500X
Primary Care Clinic/Center 261QP2300X
Radiology Clinic/Center 261QR0200X
Research Clinic/Center 261QR1100X
Special Hospital 284300000X

Addresses

Primary practice location

10140 Centurion Pkwy N
The Nemours Foundation
Jacksonville, FL 32256-0532

Mailing address

10140 Centurion Pkwy N
Managed Care Department
Jacksonville, FL 32256-0532
Phone (904) 697-5628

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, DE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040109000252 FL Part B Supplier - Clinic/Group Practice 9537072483 Receives reassigned benefits from 714 practitioners
1 other NPI on this enrollment
Practice locations: Orlando, FL; Panama City, FL; Pensacola, FL; Sanford, FL; Tallahassee, FL; Titusville, FL; Wesley Chapel, FL; Winter Garden, FL…
O20040422000840 DE Part B Supplier - Clinic/Group Practice 9537072483 Receives reassigned benefits from 516 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Milford, DE; Wilmington, DE; Seaford, DE; Newark, DE; Dover, DE; Bear, DE; Middletown, DE

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 6

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

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
10D2187354Nemours Foundation, the10140 Centurion Parkway North, Jacksonville, FL 32256Certificate of waiverJan 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Nemours Foundation75 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

83 Columbia St
Orlando, FL 32806
Phone (321) 843-3220

Ownership & related parties

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Nemours Childrens Hospital, FloridaOrlando, FL, CCN 103304 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Oct 1, 2012
Oct 1, 2012

Owned or controlled facilities with NPI records 1

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

  • The Nemours Foundation

    dba Nemours Children's Hospital

    • Children's Hospital
    • Orlando, FL
    • NPI 1245520386

    5% Or Greater Direct Ownership Interest, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 872

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 872

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351468800000",
    "number": "1386658615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10140 CENTURION PKWY N",
            "address_2": "MANAGED CARE DEPARTMENT",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560532",
            "telephone_number": "904-697-5628",
            "fax_number": "907-697-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10140 CENTURION PKWY N",
            "address_2": "THE NEMOURS FOUNDATION",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322560532",
            "telephone_number": "904-697-5628",
            "fax_number": "907-697-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE NEMOURS FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2012-10-29",
        "status": "A",
        "authorized_official_last_name": "MCKENDREE",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP, FINANCE",
        "authorized_official_telephone_number": "904-697-5628",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QG0250X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Genetics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Hearing and Speech",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Research",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.