NPIMap

Organization Active NPI

Suncoast Therapy, LLC

  • Speech-Language Pathologist
  • Jacksonville, FL
National Provider Identifier
1922674910
Registry record updated May 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
SUNCOAST THERAPY, LLC
Practice address
6859 Belfort Oaks PL
Jacksonville, FL 32216-6242
Phone
(941) 485-0121
Fax
(941) 485-0519
NPI assigned
May 31, 2021
Last updated
May 31, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2021

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

Authorized official

Name
Dawn Wildermuth, SLPNPI 1568556033
Title
Owner
Phone
(941) 485-0121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X
Marriage & Family Therapist 106H00000X
Occupational Therapy Assistant 224Z00000X
Physical Therapist 225100000X
Occupational Therapist 225X00000X
Speech-Language Pathologist 235Z00000X Primary
Behavior Analyst 103K00000X

Addresses

Primary practice location

6859 Belfort Oaks PL
Jacksonville, FL 32216-6242

Mailing address

PO Box 631278
Cincinnati, OH 45263-1278
Phone (941) 485-0121

National Provider Directory

National Provider Directory
Tax ID family
Suncoast Therapy LLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1622419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622419200000",
    "number": "1922674910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 631278",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452631278",
            "telephone_number": "941-485-0121",
            "fax_number": "941-485-0519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6859 BELFORT OAKS PL",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322166242",
            "telephone_number": "941-485-0121",
            "fax_number": "941-485-0519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNCOAST THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-31",
        "last_updated": "2021-05-31",
        "certification_date": "2021-05-31",
        "status": "A",
        "authorized_official_last_name": "WILDERMUTH",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-485-0121",
        "authorized_official_credential": "SLP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.