1820 Shore Drive Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF11260961 Issued in FL

Legal business name

1820 SHORE DRIVE OPERATIONS LLC

Doing business as

The Health and Rehabilitation Centre at Dolphins View

Practice address

1820 Shore Dr S
South Pasadena, FL 33707-4601

Phone

(727) 384-9300

Fax

(727) 343-8430

NPI assigned

Dec 27, 2011

Last updated

Nov 27, 2023By 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

Kenneth Ussery

Title

VP

Phone

(407) 571-1550

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Health and Rehabilitation Centre at Dolphins View Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1578832218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 SHORE DR S",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337074601",
            "telephone_number": "727-384-9300",
            "fax_number": "727-343-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 SHORE DR S",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337074601",
            "telephone_number": "727-384-9300",
            "fax_number": "727-343-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1820 SHORE DRIVE OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-27",
        "last_updated": "2023-11-27",
        "certification_date": "2020-04-27",
        "status": "A",
        "authorized_official_last_name": "USSERY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "407-571-1550"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF11260961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004386300",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "800 Concourse Pkwy S Ste 200",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "The Health and Rehabilitation Centre at Dolphins View",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Health and Rehabilitation Centre at Dolphins View",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• A & M Beach Optical
• Absolute Home Health III LLC
• Absolute Homemaker LLC
• Raymond Acevedo
• Adnan Shariff, Inc (Florida Foot Specialist)

• Skilled Nursing Facility in South Pasadena, FL
• Providers in South Pasadena, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.