NPIMap

Organization Active NPI

Shands Jacksonville Medical Center Inc

Doing business as Shands Jacksonville Skilled Nursing Unit

  • Skilled Nursing Facility
  • Jacksonville, FL
National Provider Identifier
1730277229
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SHANDS JACKSONVILLE MEDICAL CENTER INC
Doing business as
Shands Jacksonville Skilled Nursing Unit
Practice address
655 W 8TH St
Jacksonville, FL 32209-6511
Phone
(904) 244-8675
Fax
(904) 244-4027
NPI assigned
Oct 10, 2006
Last updated
Jul 22, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
SHANDS JACKSONVILLE MEDICAL CENTER INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Mr. Michael E Gleason
Title
VP of Finance and Treasuer
Phone
(904) 244-8675

Specialties & licenses 1

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

Addresses

Primary practice location

655 W 8TH St
Jacksonville, FL 32209-6511

Mailing address

655 W 8TH St
Jacksonville, FL 32209-6511
Phone (904) 244-8675

Other identifiers 1

IdentifierTypeStateIssuer
010070605MedicaidFL

Other names 1

  • Shands Jacksonville Skilled Nursing Unit Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080519000731 FL Part A Provider - Skilled Nursing Facility 2365456258 Practice locations: Jacksonville, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730277229. Details of each certification follow.

Skilled nursing facility certification: CCN 105961

Legal name
SHANDS JACKSONVILLE MEDICAL CENTER INC
Doing business as
UF HEALTH TRANSITIONAL CARE-JACKSONVILLE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jul 24, 1997
Last certification
Apr 24, 2024
Beds
56
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Oct 1, 1999 in FL
Enrollment address
655 West 8TH St
Jacksonville, FL 32209-6511
Nursing home name
SHANDS JACKSONVILLE MEDICAL CENTER

Other NPIs with the same Medicare PAC ID 4

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

Care Compare: Nursing home

Medicare Care Compare
Listed as
Shands Jacksonville Medical CenterCCN 105961 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Jul 24, 1997
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
5657.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory
Tax ID family
University Medical Center6 organizations share this tax ID, including this one
Part of
University Medical Center

Other organizations with this tax ID 5

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

Member organizations 2

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

Ownership & related parties

All disclosed owners & managing parties 29

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

NameRoleSinceShare
Organization, Tampa, FL Adp of the SNF Jul 17, 2025
Organization, Fort Lauderdale, FL Consulting firm Adp of the SNF Jul 17, 2025
Kent Fuchs Individual Corporate DirectorVoluntary Board Member Sep 26, 2024
Brittany Johnson Individual Operational/Managerial Control Aug 5, 2024
Bank of America, NA Organization, New York, NY Financial institution 5% Or Greater Security Interest Feb 7, 2025 7%
Patrick Green Individual Corporate OfficerChief Executive Officer Jul 10, 2023
Adp of the SNF Jul 1, 2023
Organization, Brentwood, TN LLC Adp of the SNF Sep 20, 2025
Shands Jacksonville Medical Center Inc Organization, Jacksonville, FL Corporation, Non-profit 5% Or Greater Direct Ownership Interest Oct 1, 1999 100%
Vinay Gagadam Individual Operational/Managerial Control Sep 1, 2016
Adp of the SNF Sep 1, 2016
Dean Cocchi Individual Corporate OfficerVice President and Cfo Mar 1, 2018
Adp of the SNF Dec 8, 2014
David Mann Individual Corporate DirectorVoluntary Board Member Mar 7, 2017
Marsha Powers Individual Corporate DirectorVoluntary Board Member Sep 26, 2024
Betsy Mead Individual Operational/Managerial Control Aug 5, 2024
Adp of the SNF Apr 9, 2025
Ryan Fuller Individual Corporate DirectorVoluntary Board Member Dec 13, 2024
Stephen Joel Motew Individual Corporate DirectorVoluntary Board Member Sep 26, 2024
Todd Neville Individual Corporate DirectorVoluntary Board Member Sep 26, 2024
Gregory Lewis Individual Corporate DirectorVoluntary Board Member Sep 26, 2024
Robert Stilley Individual Corporate DirectorVoluntary Board Member Nov 1, 2024
Tyika Lee Individual Operational/Managerial Control Sep 19, 2022
Cheney Gunderson Individual Operational/Managerial Control Feb 1, 2016
Adp of the SNF Feb 1, 2016
Maya Rosario Individual Operational/Managerial Control Nov 29, 2021
Adp of the SNF Nov 29, 2021
Kerin Da Cruz Individual Operational/Managerial Control Feb 18, 2024
Shands Jacksonville Healthcare Inc Organization, Jacksonville, FL Non-profit 5% Or Greater Indirect Ownership Interest Oct 1, 1999 100%
Adp of the SNF Apr 21, 2005
Andrea Lachiusa Individual Operational/Managerial Control Sep 2, 2021
Adp of the SNF Sep 2, 2021
Edmund Hunter Beebe Individual Corporate DirectorVoluntary Board Member Sep 26, 2024
Methodist Medical Center Inc Organization, Jacksonville, FL Non-profit Adp of the SNF Apr 21, 2005
Vanessa Richmond Individual Operational/Managerial Control Nov 17, 2016
Adp of the SNF Nov 17, 2016
Andrea Byrd Individual Operational/Managerial Control Oct 25, 2010
Adp of the SNF Oct 25, 2010
Jennifer Hunt Individual Corporate DirectorVoluntary Board Member Sep 26, 2024

Owners & managing parties with NPI records 7

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

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Uf Health Rehabilitation Hospital - NorthJacksonville, FL, CCN 103067 Hospital 5% Or Greater Direct Ownership Interest (49%) Sep 1, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

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

Practitioners & affiliated clinicians

Affiliated clinicians 2

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": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1730277229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-8675",
            "fax_number": "904-244-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-8675",
            "fax_number": "904-244-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANDS JACKSONVILLE MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHANDS JACKSONVILLE MEDICAL CENTER INC.",
        "enumeration_date": "2006-10-10",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "GLEASON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "VP OF FINANCE AND TREASUER",
        "authorized_official_telephone_number": "904-244-8675",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010070605",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shands Jacksonville Skilled Nursing Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.