NPIMap

Organization Active NPI

Duval Medical Investors LLC

Doing business as Life Care Center of Jacksonville

  • Skilled Nursing Facility
  • Jacksonville, FL
National Provider Identifier
1780600767
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF130471033 Issued in FL
Legal business name
DUVAL MEDICAL INVESTORS LLC
Doing business as
Life Care Center of Jacksonville
Practice address
4813 Lenoir Ave
Jacksonville, FL 32216-6015
Phone
(904) 332-4546
Fax
(904) 332-4548
NPI assigned
Jul 14, 2006
Last updated
Jun 29, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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

Authorized official

Name
Cindy S. Cross
Title
Assistant Secretary
Phone
(423) 473-5867

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF130471033 FL Primary

Addresses

Primary practice location

4813 Lenoir Ave
Jacksonville, FL 32216-6015

Mailing address

3001 Keith St NW
Cleveland, TN 37312-3713
Phone (423) 473-5751

Other identifiers 1

IdentifierTypeStateIssuer
028319300MedicaidFL

Other names 1

  • Life Care Center of Jacksonville 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
O20040726001331 FL Part A Provider - Skilled Nursing Facility 6709856032 Practice locations: Jacksonville, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780600767. Details of each certification follow.

Skilled nursing facility certification: CCN 106064

Legal name
DUVAL MEDICAL INVESTORS LLC
Doing business as
LIFE CARE CENTER OF JACKSONVILLE
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 4, 2005
Last certification
Sep 26, 2024
Beds
120
Ownership / control type
Corporation
Multi-facility organization
Life Care Centers of America
Organization structure
LLCProprietary
Enrollment address
4813 Lenoir Ave
Jacksonville, FL 32216-6015
Nursing home name
LIFE CARE CENTER OF JACKSONVILLE
Affiliated entity
LIFE CARE CENTERS OF AMERICA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Life Care Center of JacksonvilleCCN 106064 · All quality measures
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
4 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 4, 2005
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
120108.4 residents per day on average
Chain
Life Care Centers of America194 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1029117Life Care Center of Jacksonville4813 Lenoir Ave, Jacksonville, FL 32216Certificate of waiverAug 9, 2026

National Provider Directory

National Provider Directory

Locations

4813 Lenoir Ave
Jacksonville, FL 32216
Phone (904) 332-1608

Ownership & related parties

All disclosed owners & managing parties 18

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

NameRoleSinceShare
Forrest L Preston Individual 5% Or Greater Direct Ownership InterestMember Jul 23, 2002 99%
Adp of the SNF Dec 28, 2011
Direct Ownership Interest Jul 23, 2002 99%
Indirect Ownership Interest Jul 23, 2002 1%
Terry Henry Individual Corporate OfficerAssistant Treasurer of MGMT Co Nov 18, 2004
Zhi J Yu Individual Operational/Managerial Control Apr 1, 2022
Adp of the SNF Mar 7, 2025
Todd Fletcher Individual Operational/Managerial Control Dec 13, 2024
Wade Taylor Individual Operational/Managerial Control May 20, 2024
Managing Control - Governing BodyAdministrator May 20, 2024
Adp of the SNF Mar 7, 2025
Angela M. Hutchison Individual Operational/Managerial Control Sep 5, 2022
Managing Control - Governing BodyDirector Nursing Sep 5, 2022
Aubrey Preston Individual Operational/Managerial Control Dec 13, 2024
Joan E Thurmond Individual Corporate OfficerAsst Sec of MGMT Co Nov 18, 2004
Cindy S Cross Individual Corporate OfficerVP/Assistant Secretary of MGMT Co Apr 6, 2004
Organization, Cleveland, TN LLC, For-profit Adp of the SNF Dec 28, 2011
Richard Swanker Individual Corporate OfficerChief Tax Officer of MGMT Co Nov 18, 2004
Organization, Cleveland, TN LLC, For-profit Adp of the SNF Mar 6, 2025
Life Care Centers of America, Inc. Organization, Cleveland, TN Corporation, Management services company, For-profit, Chain home office Operational/Managerial Control Apr 6, 2004 100%
Adp of the SNF Mar 6, 2025
Aaron Preston Individual Operational/Managerial Control Nov 1, 2018
Managing Control - Governing BodyDivision Vice President Nov 1, 2018
Duval Medical Investors LLC Organization, Cleveland, TN LLC, For-profit Operational/Managerial Control Sep 10, 2010
Adp of the SNF Dec 28, 2011
Lisa M Lay Individual Corporate OfficerSecretary of MGMT Co Nov 18, 2004
James Ziegler Individual Operational/Managerial Control Dec 13, 2024
Developers Investment Company II, Inc Organization, Cleveland, TN Corporation, For-profit Operational/Managerial Control Jun 14, 2006
Direct Ownership Interest Jul 23, 2002 1%

Owners & managing parties with NPI records 26

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

View all 26

Facilities with the same owner 193

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

View all 193

Practitioners & affiliated clinicians

Affiliated clinicians 3

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": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782691200000",
    "number": "1780600767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 KEITH ST NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123713",
            "telephone_number": "423-473-5751",
            "fax_number": "423-339-8342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4813 LENOIR AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166015",
            "telephone_number": "904-332-4546",
            "fax_number": "904-332-4548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUVAL MEDICAL INVESTORS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A",
        "authorized_official_last_name": "CROSS",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "423-473-5867"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF130471033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "028319300",
            "state": "FL"
        }
    ],
    "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": "284 Merchant St",
            "city": "Ste Genevieve",
            "state": "MO",
            "country_code": "US",
            "postal_code": "636701610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Life Care Center of Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.