Active NPI
Atrium SNF Operating LLC
- Skilled Nursing Facility
- Jacksonville, FL
National Provider Identifier
1760009757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- ATRIUM SNF OPERATING LLC
- Practice address
- 9960 Atrium Way
Jacksonville, FL 32225-6487 - Phone
- (904) 724-4726
- NPI assigned
- Jun 25, 2020
- Organization subpart
- Yes
- Parent organization
- ATRIUM SNF HOLDINGS LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Yosef Gerson
- Title
- Analyst
- Phone
- (516) 737-0600
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
9960 Atrium Way
Jacksonville, FL 32225-6487
Mailing address
199 Community Dr
Great Neck, NY 11021-5502
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200819003229 | FL | Part A Provider - Skilled Nursing Facility | 5698191757 | Practice locations: Jacksonville, FL |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1760009757. Details of each certification follow.
Skilled nursing facility certification: CCN 105927
- Legal name
- ATRIUM SNF OPERATING LLC
- Doing business as
- FOUNTAINS REHABILITATION AT MILL COVE
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Sep 13, 1996
- Last certification
- Apr 11, 2024
- Beds
- 84
- Ownership / control type
- Limited Liability Corporation
- Multi-facility organization
- Premiere Healthcare
- Organization structure
- LLC
- Incorporated
- Jun 16, 2020 in FL
- Enrollment address
- 9960 Atrium Way
Jacksonville, FL 32225-6487 - Nursing home name
- FOUNTAINS REHABILITATION AT MILL COVE
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Fountains Rehabilitation at Mill Cove
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Limited Liability company
- Certified
- Sep 13, 1996
- Medicare certification status
- Active
- Certified beds
- 84
National Provider Directory
National Provider DirectoryNetworks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Ownership & related parties
All disclosed owners & managing parties 5
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Lisa M Sofia | Corporate Officer | Sep 1, 2020 | 100% |
| Atrium Master Holdings LLC | 5% Or Greater Indirect Ownership Interest | Jun 16, 2020 | 100% |
| Kyle Wierzba | W-2 Managing Employee | Sep 1, 2020 | 100% |
| BHP Services | 5% Or Greater Indirect Ownership Interest | Jun 16, 2020 | 100% |
| Atrium SNF Holdings LLC | 5% Or Greater Direct Ownership Interest | Jun 16, 2020 | 100% |
Facilities with the same owner 1
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
- Home Health Agency
- Philadelphia, PA
- NPI 1366673790
BHP Services
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": "1593043200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1596758400000",
"number": "1760009757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "199 COMMUNITY DR",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110215502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9960 ATRIUM WAY",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322256487",
"telephone_number": "904-724-4726"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ATRIUM SNF OPERATING LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ATRIUM SNF HOLDINGS LLC",
"enumeration_date": "2020-06-25",
"last_updated": "2020-08-07",
"certification_date": "2020-08-07",
"status": "A",
"authorized_official_last_name": "GERSON",
"authorized_official_first_name": "YOSEF",
"authorized_official_title_or_position": "ANALYST",
"authorized_official_telephone_number": "516-737-0600"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.