Organization Active NPI

Ali Angel'S Nesi

  • Assisted Living Facility
  • Jacksonville, FL
National Provider Identifier
1932626751
Registry record updated Aug 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL11369 Issued in FL
Legal business name
ALI ANGEL'S NESI
Practice address
864 Wyolen St
Jacksonville, FL 32254-2943
Phone
(904) 389-3192
NPI assigned
Aug 23, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2017

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

Authorized official

Name
Ali Elaine GreeneNPI 1053738468
Title
Administrator
Phone
(904) 389-3192

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL11369 FL Primary

Addresses

Primary practice location

864 Wyolen St
Jacksonville, FL 32254-2943

Mailing address

864 Wyolen St
Jacksonville, FL 32254-2943
Phone (904) 389-3192

Other identifiers 1

IdentifierTypeStateIssuer
001968700MedicaidFL

National Provider Directory

National Provider Directory

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": "1503446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1503446400000",
    "number": "1932626751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "864 WYOLEN ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322542943",
            "telephone_number": "904-389-3192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "864 WYOLEN ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322542943",
            "telephone_number": "904-389-3192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALI ANGEL'S NESI",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-23",
        "last_updated": "2017-08-23",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "ALI",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "904-389-3192"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL11369",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001968700",
            "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 Aug 23, 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.