PRUITTHEALTH - FLEMING ISLAND, LLC (NPI# 1649758012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649758012 |
| Entity Type | Organization |
| Organization Name | PRUITTHEALTH - FLEMING ISLAND, LLC |
| Other Organization Name | PRUITTHEALTH - FLEMING ISLAND |
| Practice Address |
2040 Town Center Boulevard Fleming Island FL 32003 |
| Mailing Address |
1626 Jeurgens Ct Norcross GA 30093-2219 |
| Practice Telephone | 9042931311 |
| Mailing Telephone | 7702796200 |
| Enumeration Date | 2018-07-30 |
| Last Update Date | 2018-11-09 |
| Authorized Official Name | NEIL L. PRUITT JR. (CHAIRMAN & CEO OF MANAGER'S MANAGER) |
| Authorized Official Telephone | 7702796200 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| PruittHealth - Fleming Island | Doing Business As Name - Organization |
| Street Address |
2040 TOWN CENTER BOULEVARD |
| City | FLEMING ISLAND |
| State | FL |
| Zip Code | 32003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841733904 | Linda Giacobbe | Community/Behavioral Health | 4609 Hwy 17, Suite 1, Fleming Island, FL 32003 | 2016-11-22 |
| 1538515796 | Kelly Standish | Dentist | 1700 Eagle Harbor Parkway East, Orange Park, FL 32003 | 2016-05-06 |
| 1396119301 | Emily Benn | Physical Therapist | 4689 Hwy 17, Suite 11, Fleming Island, FL 32003 | 2015-11-16 |
| 1467834929 | Sherrye Frady | Nurse Practitioner | 1915 East West Pkwy #2, Fleming Island, FL 32003 | 2015-06-22 |
| 1023497658 | Musa Medical Supplies | Durable Medical Equipment & Medical Supplies | 1915 Eastwest Parkway, Fleming Island, FL 32003 | 2015-05-28 |
| 1093125676 | Stephen Gibbs | Orthopaedic Surgery | 4689 Highway 17, Suite 11, Fleming Island, FL 32003 | 2014-05-05 |
| 1033555198 | Lillie Elaine Switanek | Social Worker | 1 743 Cr 220, Fleming Island, FL 32003 | 2013-05-16 |
| 1003188475 | Comfortable Care Dental Health Professionals | Dentist | 1647 Country Road 220, Suite 101, Fleming Island, FL 32003 | 2012-02-01 |
| 1285901488 | Lynzie Lane Cammilleri | Pharmacist | 1565 Doctor's Inlet, Orange Park, FL 32003 | 2011-11-17 |
| 1235435652 | Trent Charles Harrison | Physical Therapist | 1675 Eagle Harbor Parkway Ste B, Orange Park, FL 32003 | 2011-02-02 |
| Find all providers in zip 32003 | ||||
| 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 |
|---|---|---|---|---|
| 1306444708 | Center for Comprehensive Services, Inc. | Skilled Nursing Facility | 2411 Clement Rd, Lutz, FL 33549-5552 | 2020-10-16 |
| 1114530227 | Jupiter Rehab and Health Center LLC | Skilled Nursing Facility | 650 Pioneer Rd # 5, Jupiter, FL 33458-8834 | 2020-08-28 |
| 1821601089 | Wellington Rehab and Health Center, LLC | Skilled Nursing Facility | 10330 Nu Vista Ave, Wellington, FL 33414 | 2020-08-27 |
| 1043822349 | Oaks of Kissimmee Operations LLC | Skilled Nursing Facility | 320 N. Mitchell St, Kissimmee, FL 34741-4447 | 2020-08-18 |
| 1720690027 | Brynwood Operations LLC | Skilled Nursing Facility | 1656 S Jefferson St, Monticello, FL 32344-1652 | 2020-08-18 |
| 1326668120 | Key West Nursing Home Propco LLC | Skilled Nursing Facility | 5860 College Road, Key West, FL 33040 | 2020-04-21 |
| 1740800655 | Javara Troupe | Skilled Nursing Facility | 10043 Victory Gallop Loop, Ruskin, FL 33573-6744 | 2020-04-21 |
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1053944116 | Pruitthealth - Southwood, LLC | Skilled Nursing Facility | 2301 Bluff Oak Way, Tallahassee, FL 32311-6161 | 2020-02-18 |
| 1992336895 | Dolphin Pointe Health Care, LLC | Skilled Nursing Facility | 5355 Dolphin Point Rd., Jacksonville, FL 32211 | 2020-01-29 |
| Find all providers with the same taxonomy | ||||
| City | FLEMING ISLAND |
| Zip Code | 32003 |
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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.