SV - Jupiter Properties Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1434096 Issued in FL

Legal business name

SV - JUPITER PROPERTIES INC

Doing business as

Pensacola Health Care Facility

Practice address

1717 W Avery St
Pensacola, FL 32501-1811

Phone

(850) 434-2355

Fax

(850) 433-9547

NPI assigned

Dec 9, 2005

Last updated

Jun 4, 2012By 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

Mrs. Rhonda Nelson

Title

Controller

Phone

(864) 578-6599

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pensacola Health Care Facility Doing business as

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• SV - Jupiter Properties Inc

  dba Doctors Lake of Orange Park

  • Skilled Nursing Facility
  • Orange Park, FL
  • NPI 1629053962

  Member Of

  NPD member

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338768000000",
    "number": "1700861051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W AVERY ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011811",
            "telephone_number": "850-434-2355",
            "fax_number": "850-433-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W AVERY ST",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325011811",
            "telephone_number": "850-434-2355",
            "fax_number": "850-433-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SV - JUPITER PROPERTIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2012-06-04",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "864-578-6599",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1434096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "022424300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pensacola Health Care Facility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Camden Ke'Ale Sutton, MD
• Christina Ferguson Sutton, LCSW
• Tammy Sutton, LCSW
• Valerie A Sutton, A.R.N.P.
• Suzanne K. Zoss, PH.D., P.a.
• John Patrick Svoboda, RN
• Sandra Swan, PT
• Lonnie Swanagan, LCSW
• Melissa Marie Swango
• Lakeenia Swann

• Skilled Nursing Facility in Pensacola, FL
• Providers in Pensacola, 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 Jun 4, 2012; 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.