NPIMap

Organization Active NPI

John Knox Village of Central Florida, Inc

  • Primary Care Nurse Practitioner
  • Orange City, FL
National Provider Identifier
1861263147
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
Legal business name
JOHN KNOX VILLAGE OF CENTRAL FLORIDA, INC
Practice address
101 Northlake Drive
Orange City, FL 32763-6167
Phone
(386) 456-1500
Fax
(386) 456-1550
NPI assigned
Jan 15, 2024
Organization subpart
Yes
Parent organization
JOHN KNOX VILLAGE OF CENTRAL FLORIDA, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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

Authorized official

Name
Mrs. Nicole J Vega, MSN, RN, NHA
Title
Director of Clinical Services
Phone
(386) 775-3840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP2300X Primary

Addresses

Primary practice location

101 Northlake Drive
Orange City, FL 32763-6167

Mailing address

101 Northlake Dr
Orange City, FL 32763-6167
Phone (386) 775-3840

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240510003405 FL Part B Supplier - Clinic/Group Practice 4284785205 Receives reassigned benefits from 1 practitioner
Practice locations: Orange City, FL

Other NPIs with the same Medicare PAC ID 3

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

National Provider Directory

National Provider Directory
Tax ID family
Oak Park Clinic4 organizations share this tax ID, including this one
Part of
Oak Park Clinic

Other organizations with this tax ID 3

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

Locations

701 Monastery Rd
Orange City, FL 32763
Phone (386) 456-1600

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
John Knox Village of Central Florida Inc.Orange City, FL, CCN 107530 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 May 16, 1996
Jan 1, 2015

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1705276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754352000000",
    "number": "1861263147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 NORTHLAKE DR",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327636167",
            "telephone_number": "386-775-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 NORTHLAKE DRIVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327636167",
            "telephone_number": "386-456-1500",
            "fax_number": "386-456-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN KNOX VILLAGE OF CENTRAL FLORIDA, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JOHN KNOX VILLAGE OF CENTRAL FLORIDA, INC",
        "enumeration_date": "2024-01-15",
        "last_updated": "2025-08-05",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "VEGA",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL SERVICES",
        "authorized_official_telephone_number": "386-775-3840",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSN, RN, NHA"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.