DOCTORS LAKE OF ORANGE PARK
NPI 1629053962
Skilled Nursing Facility in Orange Park, FL
NPI Status: Active since December 09, 2005
Contact Information
833 KINGSLEY AVE
ORANGE PARK, FL
ZIP 32073
Phone: (904) 269-2610
Fax: (904) 269-0873
- Organization
- Skilled Nursing Facility
- CLIA Number: 10D0965864
- CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
- CLIA Exp. Date: 09-29-2025
About DOCTORS LAKE OF ORANGE PARK
This page provides the complete NPI Profile along with additional information for Doctors Lake Of Orange Park, a provider established in Orange Park, Florida operating as a Skilled Nursing Facility. The healthcare provider is registered in the NPI registry with number 1629053962 assigned on December 2005. The practitioner's primary taxonomy code is 314000000X with license number SNF1237096 (FL). The provider is registered as an organization and their NPI record was last updated 12 years ago. The provider's is doing business as Doctors Lake Of Orange Park. The authorized official of this NPI record is Mrs. Rhonda Nelson (Controller)
- NPI
- 1629053962
- Provider Legal Name
- SV - JUPITER PROPERTIES INC
- Other Organization Name
- DOCTORS LAKE OF ORANGE PARK
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 833 KINGSLEY AVE ORANGE PARK, FL 32073
- Location Phone
- (904) 269-2610
- Location Fax
- (904) 269-0873
- Mailing Address
- 833 KINGSLEY AVE ORANGE PARK, FL 32073
- Mailing Phone
- (904) 269-2610
- Mailing Fax
- (904) 269-0873
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 12-09-2005
- Last Update Date
- 06-06-2013
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Skilled Nursing Facility
- Taxonomy Code
- 314000000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- SNF1237096
- License State
- FL
- Taxonomy Description
- (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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 022388300 | MEDICAID (05) | FL | |
| 105586 | MEDICARE OSCAR/CERTIFICATION (06) | FL | |
| 5089760002 | MEDICARE NSC (07) | FL |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 10D0965864
- Facility Type
- Skilled Nursing Facility/Nursing Facility
- Certificate Effective Date
- September 30, 2023
- Certificate Expiration Date
- September 29, 2025
- Laboratory Director
- DAVID B. HARRIS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Doctors Lake Of Orange Park to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for DOCTORS LAKE OF ORANGE PARK
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 2 | 9 | 0 | 5 | 3 | 9 | 6 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 4 | 9 | 0 | 5 | 6 | 9 | 12 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 4 + 9 + 0 + 5 + 6 + 9 + 1 + 2 + 24 = 68 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 68 = 2 | 2 | ||||||||
The NPI number 1629053962 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1811317605 | ORANGE PARK MGT, LLC Organization | Skilled Nursing Facility | 833 KINGSLEY AVE ORANGE PARK, FL 32073 (904) 269-2610 |
| 1194355263 | FUCHISA ARTIS Individual | Home Health | 833 KINGSLEY AVE ORANGE PARK, FL 32073 (904) 269-2610 |
| 1720656390 | ORANGE PARK NURSING LLC Organization | Skilled Nursing Facility | 833 KINGSLEY AVE ORANGE PARK, FL 32073 (904) 269-2610 |
| 1629772363 | ORANGE PARK FL TWO OPCO LLC Organization | Skilled Nursing Facility | 833 KINGSLEY AVE ORANGE PARK, FL 32073 (904) 269-2610 |
| 1336997576 | AMAL BISHARA OTA Individual | Occupational Therapy Assistant | 833 KINGSLEY AVE ORANGE PARK, FL 32073 (904) 547-1801 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1629053962, enumerated in the NPI registry as an "organization" on December 09, 2005
The provider is located at 833 Kingsley Ave Orange Park, Fl 32073 and the phone number is (904) 269-2610
This medical organization specializes in Skilled Nursing Facility with taxonomy code 314000000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 10D0965864 for a "skilled nursing facility/nursing facility" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on December 09, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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