Active NPI
Riverwood Nursing Center LLC
- Skilled Nursing Facility
- Jacksonville, FL
National Provider Identifier
1891797874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- RIVERWOOD NURSING CENTER LLC
- Practice address
- 40 Acme St
Jacksonville, FL 32211-7953 - Phone
- (904) 724-5933
- Fax
- (904) 721-1274
- NPI assigned
- Aug 10, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Mary Lu Flory, RN NHA HR
- Title
- VP Operations
- Phone
- (770) 993-4000
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
40 Acme St
Jacksonville, FL 32211-7953
Mailing address
40 Acme St
Jacksonville, FL 32211-7953
Phone (904) 724-5933
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02509700 | Medicaid | FL |
Other names 1
- SouthWood Nursing Center Inc
National Provider Directory
National Provider Directory- Tax ID family
- Riverwood Nursing Center LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Nursing Facility/Intermediate Care Facility
- Jacksonville, FL
- NPI 1255328399
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1210723200000",
"number": "1891797874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 ACME ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322117953",
"telephone_number": "904-724-5933",
"fax_number": "904-721-1274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 ACME ST",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322117953",
"telephone_number": "904-724-5933",
"fax_number": "904-721-1274"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RIVERWOOD NURSING CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2005-08-10",
"last_updated": "2008-05-14",
"status": "A",
"authorized_official_last_name": "FLORY",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "LU",
"authorized_official_title_or_position": "VP OPERATIONS",
"authorized_official_telephone_number": "770-993-4000",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "RN NHA HR"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02509700",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "SouthWood Nursing Center Inc",
"code": "4",
"type": "Former Legal Business Name"
}
]
}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 May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.