Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Sovereign Healthcare of St Augustine, LLC

Organization Skilled Nursing Facility · NPI 1538156195

Sovereign Healthcare of St Augustine, LLC is a Skilled Nursing Facility in St Augustine, Florida. Licensed in Florida. Registered with an NPI since 2005.

Licensed in
FL
In the registry since
2005
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

200 Mariner Health Way
St Augustine, FL 32086-7226 Not confirmed with CMS for 12 years — call before visiting
Phone: (904) 797-1800
Fax: (904) 797-1803
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X · Licence SNF14600961 (FL)

Record details

NPI number1538156195
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official R. Cronquist — Manager · (404) 574-2100
Other names Moultrie Creek Nursing & Rehab Center
NPI enumeratedSeptember 29, 2005
Last updated in NPPESSeptember 24, 2014
Mailing address5887 Glenridge Dr, Suite 150, Atlanta, GA 30328-5574

Clinicians affiliated with this facility

Clinicians the CMS Facility Affiliation file lists at this facility.

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