NPIMap

Organization Active NPI

Genesis Health Development, Inc.

Doing business as Brooks Rehab Center

  • Rehabilitation Clinic/Center
  • Fernandina Beach, FL
National Provider Identifier
1740864164
Registry record updated Dec 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
GENESIS HEALTH DEVELOPMENT, INC.
Doing business as
Brooks Rehab Center
Practice address
1885 S 14TH St
Fernandina Beach, FL 32034-3033
Phone
(904) 277-4449
Fax
(904) 277-4177
NPI assigned
May 11, 2021
Last updated
Dec 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2025

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

Authorized official

Name
Jeni Allen
Title
Director, Managed Care
Phone
(904) 345-7158

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X NU Primary

Addresses

Primary practice location

1885 S 14TH St
Fernandina Beach, FL 32034-3033

Mailing address

3599 University Blvd S
Jacksonville, FL 32216-4252

Other practice location 1

450031 State Road
Ste. 2
Callahan, FL 32011-3711
Phone (904) 879-1223

Other practice location 2

463721 State Road 200 Ste 7
Yulee, FL 32097-8661
Phone (904) 602-6088

Other practice location 3

4800 First Coast Hwy Ste 240
Fernandina Beach, FL 32034-5598
Phone (904) 321-5491

Other names 1

  • Brooks Rehab Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210607000659 FL Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 4183538614 Practice locations: Callahan, FL; Fernandina Beach, FL; Yulee, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740864164. Details of each certification follow.

  • CCN 696503 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 696503

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
BROOKS REHAB CENTER-FERNANDINA
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Nov 18, 2021
Last certification
Nov 18, 2021
Ownership / control type
Voluntary Non-Profit Other Than Church
Facility address
1885 S 14TH St
Fernandina Beach, FL 32034

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
Brooks Rehab Centers9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

463721 State Road 200
Ste 7
Yulee, FL 32097
Phone (904) 602-6088

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766534400000",
    "number": "1740864164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3599 UNIVERSITY BLVD S",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1885 S 14TH ST",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320343033",
            "telephone_number": "904-277-4449",
            "fax_number": "904-277-4177"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "450031 State Road",
            "address_2": "Ste. 2",
            "address_purpose": "LOCATION",
            "city": "Callahan",
            "state": "FL",
            "postal_code": "320113711",
            "country_code": "US",
            "telephone_number": "904-879-1223",
            "fax_number": "904-879-4986",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "463721 State Road 200 Ste 7",
            "address_purpose": "LOCATION",
            "city": "Yulee",
            "state": "FL",
            "postal_code": "320978661",
            "country_code": "US",
            "telephone_number": "904-602-6088",
            "fax_number": "904-602-6091",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4800 First Coast Hwy Ste 240",
            "address_purpose": "LOCATION",
            "city": "Fernandina Beach",
            "state": "FL",
            "postal_code": "320345598",
            "country_code": "US",
            "telephone_number": "904-321-5491",
            "fax_number": "904-321-5478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GENESIS HEALTH DEVELOPMENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-11",
        "last_updated": "2025-12-24",
        "certification_date": "2025-12-24",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "JENI",
        "authorized_official_title_or_position": "DIRECTOR, MANAGED CARE",
        "authorized_official_telephone_number": "904-345-7158"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Brooks Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brooks Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fernandina Beach, FL

Sources for this page

Verify at the official NPI Registry.