Organization Active NPI

Silver Shores Living, Inc

  • Assisted Living Facility
  • Jacksonville, FL
National Provider Identifier
1831608975
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL12806 Issued in FL
Legal business name
SILVER SHORES LIVING, INC
Practice address
2317 Gilmore St
Jacksonville, FL 32204-3119
Phone
(904) 683-1580
Fax
(904) 683-2013
NPI assigned
Sep 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Garfield St. Auburn Knight
Title
Vice President
Phone
(904) 683-1580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL12806 FL Primary

Addresses

Primary practice location

2317 Gilmore St
Jacksonville, FL 32204-3119

Mailing address

2317 Gilmore St
Jacksonville, FL 32204-3119
Phone (904) 683-1580

Other identifiers 2

IdentifierTypeStateIssuer
AL12806OtherFLAGENCY FOR HEALTHCARE ADMINISTRATION (ALF LICENSE)
018329800MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1831608975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2317 GILMORE ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043119",
            "telephone_number": "904-683-1580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2317 GILMORE ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322043119",
            "telephone_number": "904-683-1580",
            "fax_number": "904-683-2013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER SHORES LIVING, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "KNIGHT",
        "authorized_official_first_name": "GARFIELD",
        "authorized_official_middle_name": "ST. AUBURN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "904-683-1580",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL12806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY FOR HEALTHCARE ADMINISTRATION (ALF LICENSE)",
            "identifier": "AL12806",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018329800",
            "state": "FL"
        }
    ],
    "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 Jul 21, 2022; 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.