NPIMap

Organization Active NPI

Brooks Skilled Nursing Facility a, Inc.

Doing business as University Crossing

  • Skilled Nursing Facility
  • Jacksonville, FL
National Provider Identifier
1669831079
Registry record updated Dec 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF1149095 Issued in FL
Legal business name
BROOKS SKILLED NURSING FACILITY A, INC.
Doing business as
University Crossing
Practice address
6210 Beach Blvd
Jacksonville, FL 32216-2706
Phone
(904) 345-8100
Fax
(904) 345-8108
NPI assigned
Feb 12, 2016
Last updated
Dec 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2025

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

Authorized official

Name
Jeni Allen
Title
Director of Managed Care
Phone
(904) 345-7158

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF1149095 FL Primary

Addresses

Primary practice location

6210 Beach Blvd
Jacksonville, FL 32216-2706

Mailing address

3599 University Blvd S
Attn: Managed Care
Jacksonville, FL 32216-4252
Phone (904) 345-7291

Other names 1

  • University Crossing 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
O20160418000589 FL Part A Provider - Skilled Nursing Facility 8628105699 Practice locations: Jacksonville, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1669831079. Details of each certification follow.

Skilled nursing facility certification: CCN 105820

Legal name
BROOKS SKILLED NURSING FACILITY, A, INC.
Doing business as
UNIVERSITY CROSSING
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 1, 1993
Last certification
Dec 19, 2024
Beds
111
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Brooks Rehabilitation
Most recent change of ownership
Jun 1, 2016
Organization structure
CorporationNon-profit
Incorporated
Mar 18, 2010 in FL
Enrollment address
6210 Beach Blvd
Jacksonville, FL 32216-2706
Nursing home name
UNIVERSITY CROSSING

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
University CrossingCCN 105820 · All quality measures
Overall star rating
4 of 5
Health inspections
4 of 5
Staffing
4 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jul 1, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
111103.6 residents per day on average

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
10D2112672Brooks Skilled Nursing Facility a Inc6210 Beach Blvd, Jacksonville, FL 32216Certificate of waiverMay 3, 2028

National Provider Directory

National Provider Directory
Tax ID family
Ability Network2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 11

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

NameRoleSinceShare
Genesis Health Inc Organization, Jacksonville, FL Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Apr 28, 1982 100%
Brooks Skilled Nursing, Inc. Organization, Jacksonville, FL Corporation, Non-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Mar 18, 2010 100%
Chonglun Xie Individual Operational/Managerial Control Jan 1, 2020
Adp of the SNF Mar 10, 2025
Victor Derienzo Individual Corporate OfficerCoo Nov 19, 2021
Individual Adp of the SNF Jan 1, 2025
Douglas Baer Individual Corporate OfficerVP Mar 18, 2010
Taylor Becht Individual Operational/Managerial Control Feb 11, 2025
Adp of the SNF Mar 10, 2025
Eric Mann Individual Corporate OfficerDirector Feb 1, 2023
Jennifer Allen Individual Operational/Managerial Control Feb 10, 2025
Forvis Mazars LLP Organization, Springfield, MO Adp of the SNF Jan 1, 2025
James Tabor Individual Corporate OfficerChief Financial Officer Feb 28, 2022

Owners & managing parties with NPI records 1

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

Facilities with the same owner 5

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

Practitioners & affiliated clinicians

Affiliated clinicians 4

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": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766448000000",
    "number": "1669831079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3599 UNIVERSITY BLVD S",
            "address_2": "ATTN: MANAGED CARE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164252",
            "telephone_number": "904-345-7291",
            "fax_number": "904-345-7284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6210 BEACH BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322162706",
            "telephone_number": "904-345-8100",
            "fax_number": "904-345-8108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKS SKILLED NURSING FACILITY A, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-12",
        "last_updated": "2025-12-23",
        "certification_date": "2025-12-23",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JENI",
        "authorized_official_title_or_position": "DIRECTOR OF MANAGED CARE",
        "authorized_official_telephone_number": "904-345-7158"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1149095",
            "primary": true
        }
    ],
    "identifiers": [],
    "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": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "University Crossing",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "University Crossing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.