NPIMap

Organization Active NPI

Sovereign Healthcare of Boynton Beach, LLC

  • Skilled Nursing Facility
  • Boynton Beach, FL
National Provider Identifier
1396732012
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF14590961 Issued in FL
Legal business name
SOVEREIGN HEALTHCARE OF BOYNTON BEACH, LLC
Practice address
9600 Lawrence Rd
Boynton Beach, FL 33436-3300
Phone
(561) 740-4100
Fax
(561) 740-4200
NPI assigned
Sep 29, 2005
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 SNF14590961 FL Primary

Addresses

Primary practice location

9600 Lawrence Rd
Boynton Beach, FL 33436-3300

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
026346000MedicaidFL
V548P-1064OtherVA

Other names 1

  • Boynton Beach Rehabilitation Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20030910000045 FL Part A Provider - Skilled Nursing Facility 1850202094 Practice locations: Boynton Beach, FL

Skilled nursing facility certification: CCN 105837

Legal name
SOVEREIGN HEALTHCARE OF BOYNTON BEACH LLC
Doing business as
BOYNTON BEACH REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 1, 1993
Last certification
Oct 14, 2024
Beds
168
Ownership / control type
Limited Liability Corporation
Organization structure
LLCProprietary
Enrollment address
9600 Lawrence Rd
Boynton Beach, FL 33436-3300
Nursing home name
BOYNTON BEACH REHABILITATION CENTER
Affiliated entity
SOVEREIGN HEALTHCARE HOLDINGS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Boynton Beach Rehabilitation CenterCCN 105837
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 1, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
168143.1 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
10D0884174Boynton Beach Rehabilitation Center9600 Lawrence Road, Boynton Beach, FL 33436Certificate of waiverMar 25, 2028

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 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)…
  • 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 18

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 BodyVP of Compliance and Quality MGMT May 19, 2009
Adp of the SNF May 19, 2009
Sovereign Healthcare Disbursements LLC Organization, Casselberry, FL LLC Adp of the SNF May 19, 2009
John F Kelly Individual Operational/Managerial Control Dec 17, 2021
Adp of the SNF Dec 17, 2021
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 Operational/Managerial Control Jan 1, 2006
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
Charles Bell Individual Managing Control - Governing BodyVice President of Operations Sep 15, 2016
Adp of the SNF Sep 15, 2016
Sovereign Healthcare Holdings LLC Organization, Atlanta, GA LLC 5% Or Greater Direct Ownership Interest Jul 21, 2003 100%
Steven M Sherman Individual Operational/Managerial Control May 1, 2026
Adp of the SNF May 1, 2026
Berkadia Commercial Mortgage LLC Organization, Horsham, PA LLC, Financial institution, Owned by another organization or individual 5% Or Greater Security Interest Sep 23, 2014 100%
Royce M Cronquist Individual Operational/Managerial Control Mar 17, 2006
Adp of the SNF Mar 17, 2006
FL Boynton Beach 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
John J Notermann Business TR Organization, Atlanta, GA 5% Or Greater Indirect Ownership Interest Nov 12, 2017 82.5%
Forvis Mazars LLP Organization, Springfield, MO Adp of the SNF May 19, 2009
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 5% Or Greater 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 42

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

View all 42

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": "1396732012",
    "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": "9600 LAWRENCE RD",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334363300",
            "telephone_number": "561-740-4100",
            "fax_number": "561-740-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN HEALTHCARE OF BOYNTON BEACH, 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": "SNF14590961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026346000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA",
            "identifier": "V548P-1064",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boynton Beach Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boynton Beach, FL

Sources for this page

Verify at the official NPI Registry.