Active NPI
Avon Park Royal Holdings LLC
Doing business as Royal Care of Avon Park
- Skilled Nursing Facility
- Avon Park, FL
National Provider Identifier
1477731529
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- SNF12290951
- Legal business name
- AVON PARK ROYAL HOLDINGS LLC
- Doing business as
- Royal Care of Avon Park
- Practice address
- 1213 W Stratford Rd
Avon Park, FL 33825-8091 - Phone
- (863) 453-6674
- Fax
- (863) 453-9473
- NPI assigned
- Jan 31, 2008
- Last updated
- Jan 9, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Pamela Matheis
- Title
- Administrator
- Phone
- (863) 453-6674
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | SNF12290951 | FL | Primary |
Addresses
Primary practice location
1213 W Stratford Rd
Avon Park, FL 33825-8091
Mailing address
1213 W Stratford Rd
Avon Park, FL 33825-8091
Phone (863) 453-6674
Other names 1
- Royal Care of Avon Park
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080611000126 | FL | Part A Provider - Skilled Nursing Facility | 7810068327 | Practice locations: Avon Park, FL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1477731529. Details of each certification follow.
Skilled nursing facility certification: CCN 105812
- Legal name
- AVON PARK ROYAL HOLDINGS LLC
- Doing business as
- ROYAL CARE OF AVON PARK
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Jul 1, 1993
- Last certification
- May 9, 2024
- Beds
- 90
- Ownership / control type
- Limited Liability Corporation
- Most recent change of ownership
- Dec 1, 2007
- Organization structure
- LLC
- Incorporated
- Oct 25, 2007 in FL
- Enrollment address
- 1213 West Stratford Road
Avon Park, FL 33825-8091 - Nursing home name
- ROYAL CARE OF AVON PARK
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Royal Care of Avon Park
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Jul 1, 1993
- Medicare certification status
- Active
- Certified beds
- 90
- Penalties (3 years)
- 2
National Provider Directory
National Provider DirectoryNetworks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Ownership & related parties
All disclosed owners & managing parties 3
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Pamela Matheis | Operational/Managerial Control | Apr 13, 2003 | |
| Adp of the SNF | Apr 7, 2003 | ||
| Donald B Geldart | Operational/Managerial Control | Jan 1, 2002 | |
| Adp of the SNF | Feb 25, 2025 | ||
| Eli Strohli | 5% Or Greater Direct Ownership Interest | Oct 25, 2007 | 100% |
Practitioners & affiliated clinicians
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Hospice and Palliative Medicine (Internal Medicine) Physician
- Plant City, FL
- NPI 1265655757
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201737600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1736380800000",
"number": "1477731529",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1213 W STRATFORD RD",
"city": "AVON PARK",
"state": "FL",
"postal_code": "338258091",
"telephone_number": "863-453-6674",
"fax_number": "863-453-9473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1213 W STRATFORD RD",
"city": "AVON PARK",
"state": "FL",
"postal_code": "338258091",
"telephone_number": "863-453-6674",
"fax_number": "863-453-9473"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AVON PARK ROYAL HOLDINGS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2008-01-31",
"last_updated": "2025-01-09",
"certification_date": "2025-01-09",
"status": "A",
"authorized_official_last_name": "MATHEIS",
"authorized_official_first_name": "PAMELA",
"authorized_official_title_or_position": "ADMINISTRATOR",
"authorized_official_telephone_number": "863-453-6674",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "FL",
"license": "SNF12290951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Royal Care of Avon Park",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Avon Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.