Organization Active NPI

Suncoast New Options 107TH Place, LLC

  • Intellectual Disabilities Intermediate Care Facility
  • Belleview, FL
National Provider Identifier
1750962213
Registry record updated Apr 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
SUNCOAST NEW OPTIONS 107TH PLACE, LLC
Practice address
5321 SE 107TH PL
Belleview, FL 34420-3231
Phone
(919) 390-2980
NPI assigned
Apr 16, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2021

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

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

5321 SE 107TH PL
Belleview, FL 34420-3231

Mailing address

6531 Meridien Dr Ste 103
Raleigh, NC 27616-3213
Phone (919) 390-2980

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1618531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618531200000",
    "number": "1750962213",
    "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",
            "telephone_number": "919-390-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5321 SE 107TH PL",
            "city": "BELLEVIEW",
            "state": "FL",
            "postal_code": "344203231",
            "telephone_number": "919-390-2980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST NEW OPTIONS 107TH PLACE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-16",
        "last_updated": "2021-04-16",
        "certification_date": "2021-04-16",
        "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": []
}

Other providers in Belleview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.