Heartland of Orange Park FL LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1211096 Issued in FL

Legal business name

HEARTLAND OF ORANGE PARK FL LLC

Practice address

570 Wells Rd
Orange Park, FL 32073-2999

Phone

(904) 264-3912

Fax

(904) 264-6751

NPI assigned

May 30, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Martin D Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heartland Health Care Center - Orange Park Doing business as

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497571200000",
    "number": "1861449258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5500",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 WELLS RD",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320732999",
            "telephone_number": "904-264-3912",
            "fax_number": "904-264-6751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND OF ORANGE PARK FL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-30",
        "last_updated": "2017-06-16",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1211096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "032526100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartland Health Care Center - Orange Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Orange Park, FL
• Providers in Orange Park, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2017; 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.