NPIMap

Organization Active NPI

Woodland Grove Healthcare & Rehabilitation Center LLC

  • Skilled Nursing Facility
  • Jacksonville, FL
National Provider Identifier
1477293090
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
WOODLAND GROVE HEALTHCARE & REHABILITATION CENTER LLC
Practice address
4325 Southpoint Blvd
Jacksonville, FL 32216-6166
Phone
(904) 245-7620
NPI assigned
Mar 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Authorized official

Name
Moshe Scheiner
Title
Authorized Official
Phone
(845) 490-6060

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

4325 Southpoint Blvd
Jacksonville, FL 32216-6166

Mailing address

4325 Southpoint Blvd
Jacksonville, FL 32216-6166

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220831000025 FL Part A Provider - Skilled Nursing Facility 6406230069 Practice locations: Jacksonville, FL

Skilled nursing facility certification: CCN 106058

Legal name
WOODLAND GROVE HEALTHCARE & REHABILITATION CENTER LLC
Doing business as
WOODLAND GROVE HEALTHCARE & REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Feb 20, 2004
Last certification
Jan 30, 2025
Beds
120
Ownership / control type
Corporation
Multi-facility organization
Paramount Healthcare Services
Most recent change of ownership
Jul 27, 2022
Organization structure
LLCProprietary
Incorporated
Jul 27, 2022 in FL
Enrollment address
4325 Southpoint Blvd
Jacksonville, FL 32216-6166
Nursing home name
WOODLAND GROVE HEALTHCARE & REHABILITATION CENTER
Affiliated entity
GOLD FL TRUST II

Care Compare: Nursing home

Medicare Care Compare
Listed as
Woodland Grove Healthcare & Rehabilitation CenterCCN 106058 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
3 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Feb 20, 2004
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120110.3 residents per day on average
Chain
Gold FL Trust II36 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
10D1021524Woodland Grove Healthcare & Rehabilitation Center4325 Southpoint Blvd, Jacksonville, FL 32216Certificate of waiverJan 25, 2028

National Provider Directory

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 7

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

NameRoleSinceShare
Silver FL Trust II Organization, Miami, FL 5% Or Greater Indirect Ownership Interest Jul 27, 2022 45%
Copper FL Trust II Organization, Miami, FL 5% Or Greater Indirect Ownership Interest Jul 27, 2022 10%
Jack Y Shelby Individual Corporate Officer Jul 27, 2022 100%
Woodland Grove SNF Holdco LLC Organization, Montebello, NY Created for acquisition, LLC, Holding company, For-profit 5% Or Greater Direct Ownership Interest Mar 23, 2022 100%
Patricia Stover Individual W-2 Managing EmployeeAdministrator Jul 27, 2022 100%
FL Master Opco Holdco LLC Organization, Miami, FL Created for acquisition, Holding company, For-profit 5% Or Greater Indirect Ownership Interest Jul 27, 2022 100%
Gold FL Trust II Organization, Miami, FL 5% Or Greater Indirect Ownership Interest Jul 27, 2022 45%

Facilities with the same owner 34

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

View all 34

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1648684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648684800000",
    "number": "1477293090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4325 SOUTHPOINT BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4325 SOUTHPOINT BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166166",
            "telephone_number": "904-245-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAND GROVE HEALTHCARE & REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-31",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-31",
        "status": "A",
        "authorized_official_last_name": "SCHEINER",
        "authorized_official_first_name": "MOSHE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "845-490-6060"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.