NPIMap

Organization Active NPI

Clay County Medical Investors, LLC

Doing business as Life Care Center of Orange Park

  • Skilled Nursing Facility
  • Orange Park, FL
National Provider Identifier
1609953215
Registry record updated Jul 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF1650096 Issued in FL
Legal business name
CLAY COUNTY MEDICAL INVESTORS, LLC
Doing business as
Life Care Center of Orange Park
Practice address
2145 Kingsley Ave
Orange Park, FL 32073-5151
Phone
(904) 272-2424
Fax
(904) 272-0013
NPI assigned
Nov 1, 2006
Last updated
Jul 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2026

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

Authorized official

Name
Cindy S Cross
Title
Assistant Secretary
Phone
(423) 473-5867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF1650096 FL Primary

Addresses

Primary practice location

2145 Kingsley Ave
Orange Park, FL 32073-5151

Mailing address

3001 Keith St NW
Cleveland, TN 37312-3713
Phone (423) 473-5751

Other identifiers 2

IdentifierTypeStateIssuer
021262800MedicaidFL
028428900MedicaidFL

Other names 1

  • Life Care Center of Orange Park Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050103000258 FL Part A Provider - Skilled Nursing Facility 2163480567 Practice locations: Orange Park, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1609953215. Details of each certification follow.

Skilled nursing facility certification: CCN 105928

Legal name
CLAY COUNTY MEDICAL INVESTORS, LLC
Doing business as
LIFE CARE CENTER OF ORANGE PARK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Sep 19, 1996
Last certification
Feb 6, 2025
Beds
180
Ownership / control type
Corporation
Multi-facility organization
Life Care Centers of America
Most recent change of ownership
Jan 19, 2005
Organization structure
LLCProprietary
Enrollment address
2145 Kingsley Ave
Orange Park, FL 32073-5151
Nursing home name
LIFE CARE CENTER OF ORANGE PARK
Affiliated entity
LIFE CARE CENTERS OF AMERICA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Life Care Center of Orange ParkCCN 105928 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
2 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Sep 19, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
180175.2 residents per day on average
Chain
Life Care Centers of America194 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0917046Life Care Center of Orange Park2145 Kingsley Ave, Orange Park, FL 32073Certificate of waiverJul 8, 2028

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Forrest L Preston Individual 5% Or Greater Indirect Ownership Interest Sep 30, 2004 100%
Operational/Managerial Control Feb 17, 2006
Adp of the SNF Jan 18, 2005
Indirect Ownership Interest Sep 30, 2004 100%
Terry Henry Individual Corporate OfficerAssistant Treasurer of MGMT Co Aug 16, 1999
Organization, Cleveland, TN LLC, For-profit Adp of the SNF Feb 27, 2025
Todd Fletcher Individual Operational/Managerial Control May 1, 2021
Organization, Cleveland, TN LLC, For-profit Adp of the SNF Jan 18, 2005
Aubrey Preston Individual Operational/Managerial Control Nov 27, 2024
Joan E Thurmond Individual Corporate OfficerAsst Sec of MGMT Co Oct 13, 2004
Cindy S Cross Individual Corporate OfficerVP/Asst Sec of MGMT Company Oct 13, 2004
Luis F Anez Individual Operational/Managerial Control Feb 7, 2017
Adp of the SNF Feb 27, 2025
Richard Swanker Individual Operational/Managerial Control Jan 1, 2022
Life Care Centers of America, Inc. Organization, Cleveland, TN Corporation, Management services company, For-profit, Chain home office, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Sep 30, 2004 100%
Operational/Managerial Control Feb 17, 2006 100%
Adp of the SNF Jan 18, 2005
Aaron Preston Individual Operational/Managerial Control Nov 1, 2018
Managing Control - Governing BodyDivision Vice Presicent Nov 1, 2018
Jessa Dickerman Individual Operational/Managerial Control May 9, 2024
Managing Control - Governing BodyAdministrator May 9, 2024
Adp of the SNF Feb 27, 2025
Lisa M Lay Individual Operational/Managerial Control Apr 24, 2017
James Ziegler Individual Operational/Managerial Control Sep 18, 2001
Nateasha a. Heller Individual Operational/Managerial Control Oct 15, 2024
Managing Control - Governing BodyDirector of Nursing Oct 15, 2024

Owners & managing parties with NPI records 26

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

View all 26

Facilities with the same owner 193

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 193

Practitioners & affiliated clinicians

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782950400000",
    "number": "1609953215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 KEITH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123713",
            "telephone_number": "423-473-5751",
            "fax_number": "423-339-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735151",
            "telephone_number": "904-272-2424",
            "fax_number": "904-272-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAY COUNTY MEDICAL INVESTORS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "423-473-5867"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1650096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021262800",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028428900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "284 Merchant St",
            "city": "Ste Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Life Care Center of Orange Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.