Oglethorpe of St Cloud LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

0949AD581501 Issued in FL

Legal business name

OGLETHORPE OF ST CLOUD LLC

Doing business as

Heroes Mile

Practice address

2775 Big John Dr
Deland, FL 32724-4000

Phone

(386) 337-7957

Fax

(386) 337-7968

NPI assigned

Jan 7, 2014

Organization subpart

No

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

Authorized official

Name

Tracy Roberts

Title

Director Revenue Cycle Management

Phone

(423) 895-0084

Specialties & licenses 2

Addresses

Other names 1

• Heroes Mile Doing business as

Locations

Practitioners 1

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

• Amit Desai, MD

  • Psychiatry Physician
  • Saint Cloud, FL
  • NPI 1639368673
  NPD (past)

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

{
    "created_epoch": "1389052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1861814022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7074 GROVE RD STE 129",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346098658",
            "telephone_number": "352-597-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2775 BIG JOHN DR",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327244000",
            "telephone_number": "386-337-7957",
            "fax_number": "386-337-7968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OGLETHORPE OF ST CLOUD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-07",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "DIRECTOR REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "423-895-0084"
    },
    "taxonomies": [
        {
            "code": "323P00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Residential Treatment Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "FL",
            "license": "0949AD581501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heroes Mile",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jasminia Magtoto Nuesa, MD
• Jose Enrique Nunez, PA-C
• Nursemd at Home, LLC
• Theresa Ann O'Conner
• Oak Manor, Inc.
• Makeeba Kati Ogunfiditimi, PMHNP-BC
• Adebayo Oke, DPT
• Peter Chika Okonkwo
• Otuome Mantu Ra Okoye, PT
• Carrie Oliver, MSW

• Substance Abuse Rehabilitation Facility in Deland, FL
• Providers in Deland, FL by specialty
• Substance Abuse Rehabilitation Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.