Organization Active NPI

The Fannie E. Taylor Home for the Aged, Inc.

  • Custodial Care Facility
  • Jacksonville, FL
National Provider Identifier
1679612147
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Custodial Care FacilityTaxonomy code 311Z00000X
License
AL5926 Issued in FL
Legal business name
THE FANNIE E. TAYLOR HOME FOR THE AGED, INC.
Practice address
3937 Spring Park Rd
Jacksonville, FL 32207-5739
Phone
(904) 636-0313
Fax
(904) 367-0021
NPI assigned
Feb 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mathew Sherburne
Title
V.P. Finance & Administration
Phone
(904) 636-0313

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL5926 FL
Custodial Care Facility 311Z00000X AL5926 FL Primary

Addresses

Primary practice location

3937 Spring Park Rd
Jacksonville, FL 32207-5739

Mailing address

6601 Chester Ave
Jacksonville, FL 32217-2252
Phone (904) 636-0313

Other names 1

  • Taylor Home Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1679612147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 CHESTER AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322172252",
            "telephone_number": "904-636-0313",
            "fax_number": "904-367-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3937 SPRING PARK RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322075739",
            "telephone_number": "904-636-0313",
            "fax_number": "904-367-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FANNIE E. TAYLOR HOME FOR THE AGED, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "SHERBURNE",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "V.P. FINANCE & ADMINISTRATION",
        "authorized_official_telephone_number": "904-636-0313"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL5926",
            "primary": false
        },
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "FL",
            "license": "AL5926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Taylor Home",
            "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 11, 2025; 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.