NPIMap

Organization Active NPI

Suncoast Therapy, LLC

  • Speech-Language Pathologist
  • Tampa, FL
National Provider Identifier
1013583004
Registry record updated May 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SUNCOAST THERAPY, LLC
Practice address
9051 Florida Mining Blvd Ste 102
Tampa, FL 33634-1240
Phone
(941) 485-0121
Fax
(941) 485-0519
NPI assigned
May 31, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dawn Wildermuth, SLP
Title
Owner
Phone
(941) 485-0121

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
Occupational Therapy AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 224Z00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

9051 Florida Mining Blvd Ste 102
Tampa, FL 33634-1240

Mailing address

PO Box 631278
Cincinnati, OH 45263-1278
Phone (941) 485-0121

National Provider Directory

National Provider Directory
Tax ID family
Suncoast Therapy LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9051 Florida Mining Blvd
Ste 102
Tampa, FL 33634
Phone (407) 716-9578

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622419200000",
    "number": "1013583004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631278",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631278",
            "telephone_number": "941-485-0121",
            "fax_number": "941-485-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9051 FLORIDA MINING BLVD STE 102",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336341240",
            "telephone_number": "941-485-0121",
            "fax_number": "941-485-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-31",
        "last_updated": "2021-05-31",
        "certification_date": "2021-05-31",
        "status": "A",
        "authorized_official_last_name": "WILDERMUTH",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-485-0121",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.