Sovereign Healthcare of Macclenny, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1222096 Issued in FL

Legal business name

SOVEREIGN HEALTHCARE OF MACCLENNY, LLC

Doing business as

MacClenny Nursing & Rehab Center

Practice address

755 S 5TH St
Macclenny, FL 32063-2685

Phone

(904) 259-4873

Fax

(904) 259-5381

NPI assigned

Sep 29, 2005

Last updated

Sep 24, 2014By 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

Mr. R. Mark Cronquist

Title

Manager

Phone

(404) 574-2100

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• MacClenny Nursing & Rehab Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720075351. Details of each certification follow.

• CCN 105737 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 105737

Legal name

SOVEREIGN HEALTHCARE OF MACCLENNY LLC

Doing business as

MACCLENNY NURSING AND REHAB CENTER

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF dual certification

Participating since

Jul 11, 1991

Last certification

Jun 19, 2025

Beds

120

Ownership / control type

Limited Liability Corporation

Multi-facility organization

Southern Healthcare Management

Most recent change of ownership

Oct 1, 2003

Organization structure

LLCProprietary

Enrollment address

755 S 5TH St
Macclenny, FL 32063-2685

Nursing home name

MACCLENNY NURSING AND REHAB CENTER

Affiliated entity

SOVEREIGN HEALTHCARE HOLDINGS

Listed as

Macclenny Nursing and Rehab CenterCCN 105737 · All quality measures

Overall star rating

5 of 5

Health inspections

5 of 5

Staffing

4 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

For profit - Limited Liability company

Certified

Jul 11, 1991

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

120102.7 residents per day on average

Chain

Sovereign Healthcare Holdings43 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

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

CLIA laboratory certificates

All disclosed owners & managing parties 19

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

Owners & managing parties with NPI records 1

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

• Michael V Sharpe, M.D.

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1750382669

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

Facilities with the same owner 41

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

• Blountstown Rehabilitation Center, LLC

  dba River Valley Rehabilitation Center

  • Skilled Nursing Facility
  • Blountstown, FL
  • NPI 1396021077

  Southern Healthcare Management LLC

  CMS ownership
• Braden River Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Bradenton, FL
  • NPI 1306199849

  Southern Healthcare Management LLC

  CMS ownership
• Carrollwood Rehabilitation Center LLC

  dba Northdale Rehabilitation Center

  • Skilled Nursing Facility
  • Tampa, FL
  • NPI 1457846453

  Southern Healthcare Management LLC

  CMS ownership
• Crestview Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Crestview, FL
  • NPI 1821374505

  Southern Healthcare Management LLC

  CMS ownership
• Fort Walton Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Fort Walton Beach, FL
  • NPI 1962788646

  Southern Healthcare Management LLC

  CMS ownership
• Lake Worth Rehabilitation Center LLC

  dba Lake Worth Rehabilitation Center

  • Skilled Nursing Facility
  • Lake Worth, FL
  • NPI 1063263861

  Southern Healthcare Management LLC

  CMS ownership
• Lanier Rehabilitation Center LLC

  • Skilled Nursing Facility
  • Jacksonville, FL
  • NPI 1932685880

  Southern Healthcare Management LLC

  CMS ownership
• Marianna Rehabilitation Center, LLC

  dba Marianna Health and Rehabilitation

  • Skilled Nursing Facility
  • Marianna, FL
  • NPI 1710795877

  Southern Healthcare Management LLC

  CMS ownership
• Marion House Rehabilitation Center, LLC

  dba Ocala Oaks Rehabilitation Center

  • Skilled Nursing Facility
  • Ocala, FL
  • NPI 1801152137

  Southern Healthcare Management LLC

  CMS ownership
• Parkview Rehabilitation Center at Winter Park LLC

  • Skilled Nursing Facility
  • Winter Park, FL
  • NPI 1881189884

  Southern Healthcare Management LLC

  CMS ownership
• Sarasota Bay Rehabilitation Center, LLC

  • Skilled Nursing Facility
  • Sarasota, FL
  • NPI 1649523184

  Southern Healthcare Management LLC

  CMS ownership
• Sovereign Healthcare of Atlantic Shores, LLC

  dba Atlantic Shores Nursing And Rehab Center

  • Skilled Nursing Facility
  • Melbourne, FL
  • NPI 1831186477

  Southern Healthcare Management LLC

  CMS ownership

Affiliated clinicians 1

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

• Michael V Sharpe, M.D.

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1750382669

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411516800000",
    "number": "1720075351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5887 GLENRIDGE DR",
            "address_2": "SUITE 150",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285574",
            "telephone_number": "404-574-2100",
            "fax_number": "404-574-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 S 5TH ST",
            "city": "MACCLENNY",
            "state": "FL",
            "postal_code": "320632685",
            "telephone_number": "904-259-4873",
            "fax_number": "904-259-5381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN HEALTHCARE OF MACCLENNY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2014-09-24",
        "status": "A",
        "authorized_official_last_name": "CRONQUIST",
        "authorized_official_first_name": "R.",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "404-574-2100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1222096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VA",
            "identifier": "V573P-6392",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026351600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MacClenny Nursing & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah Lee Slocum, MAG, RD, LD/N, CDE
• Camden Jakob Smith, D.D.S
• Jennifer Louise Snyder, MA
• Mary Elizabeth Southard, LMHC
• Southern Medical Clinic PA
• Phillip Wayne Steen, DDS
• Niesha Stevens, PTA
• Elyshia Stoutamire
• Susan Dubose
• Tailored Healthcare Inc

• Skilled Nursing Facility in Macclenny, FL
• Providers in Macclenny, 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 Sep 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.