BAY PINES VA MEDICAL CENTER (NPI# 1003070608) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003070608 |
| Entity Type | Organization |
| Organization Name | BAY PINES VA MEDICAL CENTER |
| Practice Address |
1920 Mason Ave Daytona Beach FL 32117-5103 |
| Mailing Address |
712 Derbyshire Rd Daytona Beach FL 32114-1606 |
| Practice Telephone | 3862743460 |
| Practice Fax Number | 3862743487 |
| Mailing Telephone | 3862743460 |
| Mailing Fax Number | 3862743487 |
| Enumeration Date | 2008-07-12 |
| Last Update Date | 2008-07-12 |
| Authorized Official Name | DR. PAUL V LARCKA (ACTING CHIEF PHARMACIST) |
| Authorized Official Telephone | 7273986661 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Street Address |
1920 MASON AVE |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174515654 | Florida Department of Veterans Affairs | Skilled Nursing Facility | 1920 Mason Ave, Daytona Beach, FL 32117-5103 | 2005-08-19 |
| 1982100251 | Lauren Gray | Speech-Language Pathologist | 1920 Mason Ave, Daytona Beach, FL 32117-5103 | 2018-04-04 |
| 1629578828 | Charis Tse Hamilton | Physical Therapist | 1920 Mason Ave, Daytona Beach, FL 32117-5103 | 2018-02-14 |
| 1629589486 | Marina Berube | Occupational Therapist | 1920 Mason Ave, Daytona Beach, FL 32117-5103 | 2017-10-19 |
| 1740581602 | Ilse Kluever | Physical Therapist | 1920 Mason Ave, Daytona Beach, FL 32117-5103 | 2010-11-09 |
| 1649462359 | Va Medical Center | Skilled Nursing Facility | 1920 Mason Ave, Emory L Bennett Va Nursing Home, Daytona Beach, FL 32117-5103 | 2007-08-16 |
| 1518165570 | Kathy Jo Barie | Physical Therapist | 1920 Mason Ave, Daytona Beach, FL 32117-5103 | 2007-07-10 |
| 1043439292 | Emory L Bennett Va Pharmacy | Department of Veterans Affairs (VA) Pharmacy | 1920 Mason Ave, Daytona Beach, FL 32117-5103 | 2007-04-25 |
| 1083717789 | Rhomell Carrasco Calara | Pharmacist | 1920 Mason Ave, Daytona Beach, FL 32117-5103 | 2006-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350409 | Erin Selfridge | Pharmacist | 1500 Beville Rd #300, Daytona Beach, FL 32117 | 2019-08-02 |
| 1881185494 | Wellspring Health, LLC | Chiropractor | 701 Ridgewood Ave, Holly Hills, FL 32117 | 2018-05-21 |
| 1780172791 | L & L Db, LLC | Clinic/Center | 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 | 2018-04-25 |
| 1154837789 | Brittany Nikolow | Nurse Practitioner | 1717 N. Clyde Morris, Daytona Beach, FL 32117 | 2017-12-19 |
| 1205356946 | Alejandro Andre Pabon Rodriguez | Nurse Anesthetist, Certified Registered | Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 | 2017-06-23 |
| 1316492135 | Ann Van Herck | Physical Therapist | 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 | 2016-08-22 |
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1053719559 | Alicia Graham | Case Manager/Care Coordinator | 1570 Megan Bay Circle, Holly Hill, FL 32117 | 2014-12-15 |
| 1578974440 | Halifax Senior Care Inc | Clinic/Center | 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 | 2014-05-14 |
| 1013345883 | Kist Alf, Inc | Assisted Living Facility | 1516 Carmen Avenue, Daytona Beach, FL 32117 | 2013-10-14 |
| Find all providers in zip 32117 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619413572 | Sandalwood Operating LLC | Skilled Nursing Facility | 1001 S Beach St, Daytona Beach, FL 32114-6204 | 2017-01-16 |
| 1205881646 | Northport Health Services of Florida, LLC | Skilled Nursing Facility | 1055 3rd St, Daytona Beach, FL 32117-4101 | 2006-05-24 |
| 1720033616 | Catalina Health Care Associates LLC | Skilled Nursing Facility | 820 N Clyde Morris Blvd, Daytona Beach, FL 32117-4594 | 2006-05-23 |
| 1073582219 | Terrace of Daytona Beach LLC | Skilled Nursing Facility | 1704 Huntington Village Cir, Daytona Beach, FL 32114-1484 | 2006-03-17 |
| 1770568917 | Ihs Acquisition No 103 Inc | Skilled Nursing Facility | 1350 S Nova Rd, Daytona Beach, FL 32114-5812 | 2005-12-09 |
| 1659364438 | Health Center of Daytona Beach, Inc | Skilled Nursing Facility | 550 National Health Care Dr, Daytona Beach, FL 32114-1494 | 2005-08-26 |
| 1174515654 | Florida Department of Veterans Affairs | Skilled Nursing Facility | 1920 Mason Ave, Daytona Beach, FL 32117-5103 | 2005-08-19 |
| 1386636264 | Delta Health Group Inc | Skilled Nursing Facility | 324 Wilder Blvd, Daytona Beach, FL 32114-6025 | 2005-08-17 |
| 1255943494 | Seaside Center Operations LLC | Skilled Nursing Facility | 324 Wilder Blvd, Daytona Beach, FL 32114-6025 | 2020-08-19 |
| 1164034567 | Coastal Center Operations LLC | Skilled Nursing Facility | 820 N Clyde Morris Blvd, Daytona Beach, FL 32117-4594 | 2020-08-18 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32117 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.