NPIMap

Organization Active NPI

11565 Harts Road Operations LLC

Doing business as Harts Harbor Health Care Center

  • Skilled Nursing Facility
  • Jacksonville, FL
National Provider Identifier
1669741302
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF15640961 Issued in FL
Legal business name
11565 HARTS ROAD OPERATIONS LLC
Doing business as
Harts Harbor Health Care Center
Practice address
11565 Harts Rd
Jacksonville, FL 32218-3777
Phone
(904) 751-1834
Fax
(904) 751-0272
NPI assigned
Dec 27, 2011
Last updated
Sep 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Authorized official

Name
Miriam C. Pastor
Title
Manager
Phone
(786) 457-2383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF15640961 FL Primary

Addresses

Primary practice location

11565 Harts Rd
Jacksonville, FL 32218-3777

Mailing address

11565 Harts Rd
Jacksonville, FL 32218-3777
Phone (904) 751-1834

Other identifiers 1

IdentifierTypeStateIssuer
004386500MedicaidFL

Other names 1

  • Harts Harbor Health Care Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726185600000",
    "number": "1669741302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11565 HARTS RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322183777",
            "telephone_number": "904-751-1834",
            "fax_number": "904-751-0272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11565 HARTS RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322183777",
            "telephone_number": "904-751-1834",
            "fax_number": "904-751-0272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "11565 HARTS ROAD OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-27",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A",
        "authorized_official_last_name": "PASTOR",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "786-457-2383"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF15640961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004386500",
            "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": "Harts Harbor Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Harts Harbor Health Care Center",
            "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 Sep 13, 2024; 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.