TANDEM HEALTH CARE OF JACKSONVILLE, INC. (NPI# 1982644712) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982644712 |
| Entity Type | Organization |
| Organization Name | TANDEM HEALTH CARE OF JACKSONVILLE, INC. |
| Other Organization Name | TANDEM HEALTH CARE OF JACKSONVILLE |
| Practice Address |
4101 Southpoint Dr E Jacksonville FL 32216-0996 |
| Mailing Address |
800 Concourse Pkwy S Suite 200 Maitland FL 32751-6148 |
| Practice Telephone | 9042966800 |
| Practice Fax Number | 9042961398 |
| Mailing Telephone | 4075711550 |
| Mailing Fax Number | 4075711599 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JOSEPH CONTE (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 4075711550 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | SNF1647096 | FL | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 226696 | 05 |
| Other Name | Type Code |
|---|---|
| Tandem Health Care of Jacksonville | Doing Business As Name - Organization |
| Street Address |
4101 SOUTHPOINT DR E |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216-0996 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649898123 | Joshua Gauger | Physical Therapy Assistant | 4101 Southpoint Dr E, Jacksonville, FL 32216-0996 | 2020-07-10 |
| 1699323063 | Miranda J. Swindell | Physical Therapy Assistant | 4101 Southpoint Dr E, Jacksonville, FL 32216-0996 | 2019-08-29 |
| 1285128108 | Brittany Elizabeth Chancey | Speech-Language Pathologist | 4101 Southpoint Dr E, Jacksonville, FL 32216-0996 | 2018-06-15 |
| 1689189730 | Sarah Davis | Physical Therapy Assistant | 4101 Southpoint Dr E, Jacksonville, FL 32216-0996 | 2017-12-12 |
| 1548775786 | Holly Ann Shaw | Physical Therapist | 4101 Southpoint Dr E, Jacksonville, FL 32216-0996 | 2017-12-11 |
| 1457875478 | Katherine Bailey Stone | Speech-Language Pathologist | 4101 Southpoint Dr E, Jacksonville, FL 32216-0996 | 2017-08-01 |
| 1184144917 | Randy Bugnon | Occupational Therapy Assistant | 4101 Southpoint Dr E, Jacksonville, FL 32216-0996 | 2017-06-22 |
| 1922536358 | Erika V Rodriguez | Occupational Therapy Assistant | 4101 Southpoint Dr E, Jacksonville, FL 32216-0996 | 2017-05-30 |
| 1538602388 | Nnonye Umerah | Occupational Therapist | 4101 Southpoint Dr E, Jacksonville, FL 32216-0996 | 2016-11-28 |
| 1669923116 | Andrew Thomas Mosier | Physical Therapy Assistant | 4101 Southpoint Dr E, Jacksonville, FL 32216-0996 | 2016-10-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| 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 |
|---|---|---|---|---|
| 1578199303 | First Coast Health Ventures, LLC | Skilled Nursing Facility | 15480 Max Leggett Parkway, Jacksonville, FL 32218 | 2020-03-12 |
| 1992336895 | Dolphin Pointe Health Care, LLC | Skilled Nursing Facility | 5355 Dolphin Point Rd., Jacksonville, FL 32211 | 2020-01-29 |
| 1629439260 | West Jax Geriatrics, LLC | Skilled Nursing Facility | 730 College St, Jacksonville, FL 32204-3313 | 2016-03-10 |
| 1376955377 | Edwin Bato | Skilled Nursing Facility | 3434 Nightscape Cir, Jacksonville, FL 32224-1618 | 2014-05-24 |
| 1508138678 | Terri Velinda Virgil | Skilled Nursing Facility | 11555 Birch Forest Circle East, Jacksonville, FL 32218 | 2012-02-03 |
| 1689993032 | Jacksonville Scc, LLC | Skilled Nursing Facility | 810 Bellaire St, Jacksonville, TX 75766-9045 | 2010-05-25 |
| 1326362005 | Brooks Skilled Nursing Facility, A, Inc. | Skilled Nursing Facility | 6209 Brooks Bartram Dr. Bldg 100, Jacksonville, FL 32258 | 2010-03-24 |
| 1144476946 | Magnus Opus Technology | Skilled Nursing Facility | 7000 Northlake Dr, Jacksonville, AR 72076-4959 | 2008-08-12 |
| 1972796175 | Russell Wayne Tolliver | Skilled Nursing Facility | 4083 Sunbeam Rd, Apartment 1409, Jacksonville, FL 32257-8993 | 2007-08-21 |
| 1750409082 | Patti Sperling Arnp LLC | Skilled Nursing Facility | 402 Myrtlewood Cir, Jacksonville, NC 28546-7412 | 2007-03-26 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
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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.