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MARY PETERSON ADMINISTRATOR
NPI 1063221646
Assisted Living Facility in Jacksonville, FL

Active since January 07, 2025
1622 SILVER ST, JACKSONVILLE, FL 32206(904) 356-3022(904) 350-9165 Get Directions Write a Review

NPPES record last updated: January 7, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mary Peterson Administrator NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY PETERSON ADMINISTRATOR (NPI 1063221646) is an individual assisted living facility provider in Jacksonville, Florida, licensed in Florida (8638) and active in the NPI registry since January 2025.

NPPES Registry Identity

NPI1063221646
Entity TypeIndividualFemale
Primary Taxonomy310400000X
Provider Legal NameMARY PETERSONCredential: ADMINISTRATOR
Location Address1622 SILVER STJacksonville, FL 32206-4446
Mailing Address1622 Silver StJacksonville, FL 32206-4446 · (904) 356-3022 · Fax (904) 356-3022
Phone(904) 356-3022
Fax(904) 350-9165
Sole ProprietorYes
Enumeration DateJanuary 7, 2025
NPPES CertifiedJanuary 7, 2025
✔ NPI 1063221646 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in FL · 8638
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
1622 SILVER ST, Jacksonville, FL 32206
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PETERSON ASSISTED LIVING FACILITY
Assisted Living Facility
1622 SILVER ST
JACKSONVILLE, FL 32206
Duval County (904) 356-3022

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Peterson's NPI number?

The NPI number for Mary Peterson is 1063221646. It was assigned to this individual provider in the NPPES registry on January 7, 2025.

Where is Mary Peterson located?

Mary Peterson practices at 1622 Silver St, Jacksonville, FL 32206. The listed phone number is (904) 356-3022.

What is Mary Peterson's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Mary Peterson was last updated on January 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.