St Petersburg Facility Operations, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1639096 Issued in FL

Legal business name

ST PETERSBURG FACILITY OPERATIONS, LLC

Practice address

9393 Park Blvd
Seminole, FL 33777-4140

Phone

(727) 391-2200

Fax

(727) 319-2611

NPI assigned

Jul 25, 2006

Organization subpart

No

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

Authorized official

Name

Kenneth Ussery

Title

VP

Phone

(407) 571-1550

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Living Center of St. Petersburg Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640131200000",
    "number": "1700809662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9393 PARK BLVD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337774140",
            "telephone_number": "727-391-2200",
            "fax_number": "727-319-2611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9393 PARK BLVD",
            "city": "SEMINOLE",
            "state": "FL",
            "postal_code": "337774140",
            "telephone_number": "727-391-2200",
            "fax_number": "727-319-2611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST PETERSBURG FACILITY OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A",
        "authorized_official_last_name": "USSERY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "407-571-1550"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1639096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008040900",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "affiliationName": "Consulate Healthcare",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "800 Concourse Pkwy S Ste 200",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Living Center of St. Petersburg",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christina Marie Spelich
• Kandi Spencer, LMHC
• Alexander Spivak, DMD
• Scott-Michael Ross Springstead, RN
• Michael P Spuza, MD
• John Matthew Stansberry
• Stat One Urgent Care, LLC
• Kimberly Stegmaier
• Victoria Procopion Stein, PHARM. D.
• Stephen C Morris DDS PA

• Skilled Nursing Facility in Seminole, FL
• Providers in Seminole, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 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.