NPIMap

Organization Active NPI

Florida Department of Veterans Affairs

  • Assisted Living Facility
  • Lake City, FL
National Provider Identifier
1962494518
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
AL7975 Issued in FL
Legal business name
FLORIDA DEPARTMENT OF VETERANS AFFAIRS
Practice address
751 SE Sycamore Ter
Lake City, FL 32025-6216
Phone
(386) 758-0600
Fax
(386) 758-0549
NPI assigned
Aug 19, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Authorized official

Name
Mr. William C Puckett
Title
Program Director
Phone
(727) 518-3202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X AL7975 FL Primary

Addresses

Primary practice location

751 SE Sycamore Ter
Lake City, FL 32025-6216

Mailing address

751 SE Sycamore Ter
Lake City, FL 32025-6216
Phone (386) 758-0600

Other names 1

  • Robert H Jenkins Jr Veterans Domiciliary Home of Florida Other name

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
10D0951911Robert H Jenkins Jr Veterans' Domiciliary Home of751 SE Sycamore Terrace, Lake City, FL 32025Certificate of waiverSep 29, 2026

National Provider Directory

National Provider Directory
Tax ID family
Florida Department of Veterans Affairs12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1962494518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "751 SE SYCAMORE TER",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256216",
            "telephone_number": "386-758-0600",
            "fax_number": "386-758-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 SE SYCAMORE TER",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320256216",
            "telephone_number": "386-758-0600",
            "fax_number": "386-758-0549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DEPARTMENT OF VETERANS AFFAIRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-19",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "PUCKETT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "727-518-3202",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "AL7975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert H Jenkins Jr Veterans Domiciliary Home of Florida",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Robert H Jenkins Jr Veterans Domiciliary Home of Florida",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.