Suncoast New Options Walnut Street, LLC

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

SUNCOAST NEW OPTIONS WALNUT STREET, LLC

Practice address

102 Alexander Rd
Starke, FL 32091-4521

Phone

(919) 390-2980

NPI assigned

Apr 22, 2021

Organization subpart

No

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

Authorized official

Name

Mary Johns Benson

Title

Director of Billing

Phone

(336) 553-5946

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 10G122

Legal name

SUNCOAST NEW OPTIONS WALNUT STREET, LLC

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Jan 26, 1994

Last certification

May 21, 2025

Beds

6

Ownership / control type

Private (non-profit)

Facility address

102 Alexander Road
Starke, FL 32091

Tax ID family

Suncoast New Options Walnut Street LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Suncoast New Options Walnut Street, LLC

  • Intellectual Disabilities Intermediate Care Facility
  • Starke, FL
  • NPI 1013581859
  NPD tax ID

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1114509858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6531 MERIDIEN DR STE 103",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276163213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 ALEXANDER RD",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320914521",
            "telephone_number": "919-390-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST NEW OPTIONS WALNUT STREET, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "BENSON",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JOHNS",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING",
        "authorized_official_telephone_number": "336-553-5946"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Farrah Starling
• Nicole Street
• Crystal Sumpter, LPN
• Suncoast New Options Bessent Road, LLC
• Suncoast New Options Walnut Street, LLC
• Sunrise Community, Inc.
• Sunrise Community, Inc.
• Elizabeth Taylor
• Tazzie Harrison, Aprn, Pmhnp-BC, LLC
• The Arc of Bradford County, Inc.

• Intellectual Disabilities Intermediate Care Facility in Starke, FL
• Providers in Starke, FL by specialty
• Intellectual Disabilities Intermediate Care Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.