Northern Jacksonville Acquisitions, LLC

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

Legal business name

NORTHERN JACKSONVILLE ACQUISITIONS, LLC

Doing business as

Summer Brook Health Care Center

Practice address

5377 Moncrief Rd
Jacksonville, FL 32209-3159

Phone

(786) 207-2108

Fax

(866) 293-2100

NPI assigned

Sep 10, 2012

Last updated

Dec 20, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael Greenwald

Title

Owner/ Manager

Phone

(786) 207-2108

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Summer Brook Health Care Center Doing business as

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387497600000",
    "number": "1538418249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5377 MONCRIEF RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322093159",
            "telephone_number": "786-207-2108",
            "fax_number": "866-293-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5377 MONCRIEF RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322093159",
            "telephone_number": "786-207-2108",
            "fax_number": "866-293-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN JACKSONVILLE ACQUISITIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-10",
        "last_updated": "2013-12-20",
        "status": "A",
        "authorized_official_last_name": "GREENWALD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/ MANAGER",
        "authorized_official_telephone_number": "786-207-2108",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "FL",
            "license": null,
            "primary": true
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005978300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "10-5138",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summer Brook Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Facility/Intermediate Care Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Nursing Facility/Intermediate Care Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2013; 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.