WEST JAX SKILLED NURSING NPI 1063898864

NPI Information

  • NPI: 1063898864
  • Provider Name: WEST JAX SKILLED NURSING
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Address: 100 CYPRESS LAGOON CT
    PONTE VEDRA BEACH, FL
    ZIP 32082
  • Phone: (904) 783-2405

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NPI Details

WEST JAX SKILLED NURSING is a family medicine in Ponte Vedra Beach, FL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. WEST JAX SKILLED NURSING NPI is 1063898864. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

100 CYPRESS LAGOON CT
PONTE VEDRA BEACH, FL
ZIP 32082-106
Phone: (904) 783-2405
Fax: (904) 786-4981

The provider's authorized official is Michael Victor Sharpe .
The authorized official title is Supervisor and has the following contact phone number (904) 783-2405.

The enumeration date for this NPI number is 8/4/2015 and was last updated on 8/4/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine1285048280FLORIDANo
2207Q00000XFamily Medicine1750382669FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
104127TMEDICARE UPINFLORIDA
2620455400MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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