Organization Active NPI

Suncoast Integrative Healthcare LLC

  • General Practice Physician
  • St Petersburg, FL
National Provider Identifier
1619528932
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
SUNCOAST INTEGRATIVE HEALTHCARE LLC
Practice address
6514 Central Ave
Saint Petersburg, FL 33707-1330
Phone
(727) 519-3757
NPI assigned
Sep 27, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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

Authorized official

Name
Colby StaubsNPI 1578880357
Title
President
Phone
(727) 519-3757

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

6514 Central Ave
Saint Petersburg, FL 33707-1330

Mailing address

6514 Central Ave
Saint Petersburg, FL 33707-1330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200318001259 FL Part B Supplier - Clinic/Group Practice 8527496918 Receives reassigned benefits from 3 practitioners
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584489600000",
    "number": "1619528932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6514 CENTRAL AVE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337071330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6514 CENTRAL AVE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337071330",
            "telephone_number": "727-519-3757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST INTEGRATIVE HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-27",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A",
        "authorized_official_last_name": "STAUBS",
        "authorized_official_first_name": "COLBY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-519-3757"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.