Senior Care of St Johns Operator LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF 1521096 Issued in FL

Legal business name

SENIOR CARE OF ST JOHNS OPERATOR LLC

Doing business as

St Johns Health Care Center

Practice address

189 San Marco Ave
St Augustine, FL 32084-2733

Phone

(904) 824-3326

Fax

(904) 825-0593

NPI assigned

Jun 28, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Robert Daniel Vaughan

Title

Director of Operations

Phone

(770) 255-1810

Specialties & licenses 1

Addresses

Other names 1

• St Johns Health Care Center Doing business as

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992732473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 NORCROSS ST",
            "address_2": "SUITE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300753810",
            "telephone_number": "770-255-1810",
            "fax_number": "770-255-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 SAN MARCO AVE",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842733",
            "telephone_number": "904-824-3326",
            "fax_number": "904-825-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENIOR CARE OF ST JOHNS OPERATOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VAUGHAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "770-255-1810",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF 1521096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Johns Health Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.