Suncoast New Options Bessent Road, LLC

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

SUNCOAST NEW OPTIONS BESSENT ROAD, LLC

Practice address

1329 Bessent Rd
Starke, FL 32091-3607

Phone

(919) 390-2980

NPI assigned

Apr 21, 2021

Last updated

Apr 21, 2021By the provider in NPPES

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1629650510. Details of each certification follow.

• CCN 10G112 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 10G112

Legal name

SUNCOAST NEW OPTIONS BESSENT ROAD, LLC

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Mar 10, 1994

Last certification

Mar 4, 2025

Beds

6

Ownership / control type

Private (non-profit)

Facility address

1329 Bessent Road
Starke, FL 32091

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

{
    "created_epoch": "1618963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1629650510",
    "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": "1329 BESSENT RD",
            "city": "STARKE",
            "state": "FL",
            "postal_code": "320913607",
            "telephone_number": "919-390-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST NEW OPTIONS BESSENT ROAD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-21",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "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": []
}

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• 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 21, 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.