Wyndham Lakes Jacksonville LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WYNDHAM LAKES JACKSONVILLE LLC

Doing business as

Wyndham Lakes Jacksonville

Practice address

10660 Old Saint Augustine Rd
Jacksonville, FL 32257-1076

Phone

(904) 875-8325

NPI assigned

May 28, 2026

Organization subpart

No

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

Authorized official

Name

Geoffrey Gane

Title

Financial Officer

Phone

(904) 262-4600

Specialties & licenses 1

Addresses

Other names 1

• Wyndham Lakes Jacksonville Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1779926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779926400000",
    "number": "1952232886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N MAIN ST",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10660 OLD SAINT AUGUSTINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322571076",
            "telephone_number": "904-875-8325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYNDHAM LAKES JACKSONVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-28",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A",
        "authorized_official_last_name": "GANE",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_title_or_position": "FINANCIAL OFFICER",
        "authorized_official_telephone_number": "904-262-4600"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wyndham Lakes Jacksonville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Casey Wylie, LMHC
• Natasha Subhan Wylie, ARNP, DNP
• Todd Wick Wylie, M.D.
• Christopher Edward Wyman
• Jordan Taylor-Hoprich Wyman, DNP
• Carol J Wyninger, M.D.
• Clarissa M. Wynn, PTA
• Erika Wynn, M.S.
• Gregory Carl Wynn, M.D.
• Lindsay Michele Wynn, DPM

• Assisted Living Facility in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Assisted Living Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.