NPIMap

Organization Active NPI

Lutheran Social Services of NE FL Inc

  • Case Management Agency
  • Jacksonville, FL
National Provider Identifier
1538108451
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
LUTHERAN SOCIAL SERVICES OF NE FL INC
Practice address
4615 Philips Highway
Jacksonville, FL 32207-7265
Phone
(904) 448-5995
Fax
(904) 730-8296
NPI assigned
Jun 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Authorized official

Name
Mr. Richard Joseph Mochowski
Title
Controller
Phone
(904) 730-8224

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

4615 Philips Highway
Jacksonville, FL 32207-7265

Mailing address

4615 Philips Highway
Jacksonville, FL 32207-7265
Phone (904) 448-5995

Other identifiers 1

IdentifierTypeStateIssuer
029597302MedicaidFL

National Provider Directory

National Provider Directory

Locations

4615 Philips Hwy
Jacksonville, FL 32207
Phone (904) 448-5995

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456963200000",
    "number": "1538108451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4615 PHILIPS HIGHWAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322077265",
            "telephone_number": "904-448-5995",
            "fax_number": "904-730-8296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4615 PHILIPS HIGHWAY",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322077265",
            "telephone_number": "904-448-5995",
            "fax_number": "904-730-8296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUTHERAN SOCIAL SERVICES OF NE FL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2016-03-03",
        "status": "A",
        "authorized_official_last_name": "MOCHOWSKI",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "904-730-8224",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029597302",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Mar 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.