Jacksonville Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

JACKSONVILLE OPCO LLC

Doing business as

The Terrace of Jacksonville

Practice address

10680 Old Saint Augustine Rd
Jacksonville, FL 32257-1000

Phone

(904) 268-4953

NPI assigned

Aug 31, 2017

Last updated

Aug 31, 2017By 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

Cameron Marsh

Title

Corporate Finance

Phone

(386) 255-1054

Specialties & licenses 1

Addresses

Other names 1

• The Terrace of Jacksonville Doing business as

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504137600000",
    "number": "1740708635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 FENTRESS BLVD STE H",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10680 OLD SAINT AUGUSTINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322571000",
            "telephone_number": "904-268-4953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSONVILLE OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-31",
        "last_updated": "2017-08-31",
        "status": "A",
        "authorized_official_last_name": "MARSH",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_title_or_position": "CORPORATE FINANCE",
        "authorized_official_telephone_number": "386-255-1054"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Terrace of Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Jacksonville, FL
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• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2017; 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.