NPIMap

Organization Active NPI

Wesley Manor, Inc.

Doing business as Westminster Woods on Julington Creek

  • Skilled Nursing Facility
  • Jacksonville, FL
National Provider Identifier
1891721924
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
SNF15900961 Issued in FL
Legal business name
WESLEY MANOR, INC.
Doing business as
Westminster Woods on Julington Creek
Practice address
25 State Road 13
Jacksonville, FL 32259-2842
Phone
(904) 287-7315
Fax
(904) 287-4615
NPI assigned
Jun 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Henry T Keith
Title
Chief Financial Officer
Phone
(407) 839-5050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X SNF15900961 FL Primary

Addresses

Primary practice location

25 State Road 13
Jacksonville, FL 32259-2842

Mailing address

80 W Lucerne Cir
Orlando, FL 32801-3779
Phone (407) 839-5050

Other names 1

  • Westminster Woods on Julington Creek Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091210000389 FL Part A Provider - Skilled Nursing Facility 2668512377 Practice locations: Jacksonville, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891721924. Details of each certification follow.

Skilled nursing facility certification: CCN 105901

Legal name
WESLEY MANOR, INC.
Doing business as
WESTMINSTER WOODS ON JULINGTON CREEK
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Mar 5, 1996
Last certification
Nov 15, 2024
Beds
60
Ownership / control type
Nonprofit Corporation
Multi-facility organization
Westminster Communities of Florida
Organization structure
CorporationProprietary
Incorporated
Mar 14, 1961 in FL
Enrollment address
25 State Road 13
Jacksonville, FL 32259-2899
Nursing home name
WESTMINSTER WOODS ON JULINGTON CREEK
Affiliated entity
WESTMINSTER COMMUNITIES OF FLORIDA

Care Compare: Nursing home

Medicare Care Compare
Listed as
Westminster Woods on Julington CreekCCN 105901 · 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
Non profit - Corporation
Certified
Mar 5, 1996
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
6055.6 residents per day on average
Chain
Westminster Communities of Florida9 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
10D0863093Westminister Woods on Julington Creek25 State Road 13, Jacksonville, FL 32259Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 7

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

NameRoleSinceShare
Henry Keith Individual 5% Or Greater Indirect Ownership InterestCfo Apr 1, 2000 100%
Corporate OfficerCfo Jan 1, 1994
Andy Andre Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Apr 16, 2025
Garry Hennis Individual Corporate OfficerCoo & Evp Jan 1, 2024
Donald D Doddridge Individual Corporate DirectorDirector Jan 1, 2025
Megan Faubel Individual Corporate OfficerSecretary Jan 1, 2024
Westminster Services Inc Organization, Orlando, FL Corporation, Non-profit, Chain home office 5% Or Greater Indirect Ownership Interest Apr 1, 2000 100%
Dalia Elramady Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Apr 16, 2025

Owners & managing parties with NPI records 1

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

Facilities with the same owner 6

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 9

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": "1151020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891721924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 W LUCERNE CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328013779",
            "telephone_number": "407-839-5050",
            "fax_number": "407-849-1718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 STATE ROAD 13",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322592842",
            "telephone_number": "904-287-7315",
            "fax_number": "904-287-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY MANOR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "407-839-5050",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF15900961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westminster Woods on Julington Creek",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.