NPIMap

Organization Active NPI

Alivia Care Solutions, Inc.

Doing business as Alivia Primary Care

  • Primary Care Nurse Practitioner
  • Jacksonville, FL
National Provider Identifier
1487407235
Registry record updated Apr 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
ALIVIA CARE SOLUTIONS, INC.
Doing business as
Alivia Primary Care
Practice address
4266 Sunbeam Rd
Jacksonville, FL 32257-2425
Phone
(904) 268-5200
NPI assigned
Apr 10, 2024
Last updated
Apr 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2024

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

Authorized official

Name
Susan Ponder-Stansel
Title
President & Ceo
Phone
(904) 407-5050

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X
Geriatric Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QG0300X
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

4266 Sunbeam Rd
Jacksonville, FL 32257-2425

Mailing address

4266 Sunbeam Rd
Jacksonville, FL 32257-2425
Phone (904) 407-5050

Other names 1

  • Alivia Primary Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220302001251 FL Part B Supplier - Clinic/Group Practice 0648688044 Receives reassigned benefits from 16 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jacksonville, FL

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Alivia Supportive Care5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Practitioners & affiliated clinicians

Practitioners 16

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 16

NPI Registry JSON

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

{
    "created_epoch": "1712707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712707200000",
    "number": "1487407235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4266 SUNBEAM RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572425",
            "telephone_number": "904-407-5050",
            "fax_number": "904-407-8123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4266 SUNBEAM RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322572425",
            "telephone_number": "904-268-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALIVIA CARE SOLUTIONS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-10",
        "last_updated": "2024-04-10",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "PONDER-STANSEL",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "904-407-5050"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alivia Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.