WICKSHIRE COUNTRYSIDE OPCO LLC (NPI# 1750989687) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750989687 |
| Entity Type | Organization |
| Organization Name | WICKSHIRE COUNTRYSIDE OPCO LLC |
| Practice Address |
3141 N Mcmullen Booth Rd Clearwater FL 33761-2035 |
| Mailing Address |
750 Old Hickory Blvd Brentwood TN 37027-4528 |
| Practice Telephone | 7277237110 |
| Mailing Telephone | 6159420240 |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2020-10-13 |
| Authorized Official Name | DAN O'KEEFE (CEO) |
| Authorized Official Telephone | 6159420240 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311500000X | Alzheimer Center (Dementia Center) | Nursing & Custodial Care Facilities | ||
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Wickshire Countryside | Doing Business As Name - Organization |
| Street Address |
3141 N MCMULLEN BOOTH RD |
| City | CLEARWATER |
| State | FL |
| Zip Code | 33761-2035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295852853 | Kim Ellen D'ambra | Occupational Therapist | 3141 N Mcmullen Booth Rd, Clearwater, FL 33761-2035 | 2007-03-26 |
| 1144558180 | Charles Richard Leidner | Specialist | 3141 N Mcmullen Booth Rd, Clearwater, FL 33761-2035 | 2009-12-03 |
| 1558699561 | Barbara Denise Durr | Physical Therapy Assistant | 3141 N Mcmullen Booth Rd, Clearwater, FL 33761-2035 | 2009-12-02 |
| 1982832408 | Sharon Ann Nelson | Physical Therapist | 3141 N Mcmullen Booth Rd, Clearwater, FL 33761-2035 | 2009-06-23 |
| 1922240738 | Emily Parris Mcdonough | Speech-Language Pathologist | 3141 N Mcmullen Booth Rd, Clearwater, FL 33761-2035 | 2009-03-26 |
| 1669592382 | Marsha Jane Clanton | Physical Therapy Assistant | 3141 N Mcmullen Booth Rd, Clearwater, FL 33761-2035 | 2007-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770184210 | Sandra Shanice Campisi | Behavior Technician | 29228 Us-19 N, Clearwater, FL 33761 | 2020-11-02 |
| 1659838449 | Branden Kleehammer | Occupational Therapy Assistant | 6941 300th Ave N, Clearwater, FL 33761 | 2019-02-27 |
| 1063901403 | Sheleaha C Egly I | Behavior Technician | 29288 Us Highway 19 N, Clearwater, FL 33761 | 2018-05-01 |
| 1760979629 | Melissa Irene Valentine | Social Worker | 6997 300th Ave North, Clearwater, FL 33761 | 2018-04-17 |
| 1871011049 | Maria's Adult Day Care Center | Clinic/Center | 26224 Us Highway 19 N., Clearwater, FL 33761 | 2017-09-07 |
| 1962933739 | Robert Hudson | Occupational Therapist | 3463 Northridge Dr, Clearwater, FL 33761 | 2017-03-23 |
| 1366985582 | Brandon Chad Brown | Physician Assistant | 29277 Hwy 19 North, Clearwater, FL 33761 | 2016-11-19 |
| 1730575606 | Layne S Winker | Physician Assistant | 26812 Us 19 N # 19, Clearwater, FL 33761 | 2015-04-08 |
| 1407254907 | M Christina Memoli Od Pa | Optometrist | 27901 Us 19 N, Clearwater, FL 33761 | 2014-12-15 |
| 1952729774 | Gina Pietras Spohn | Dermatology | 3165 N Mcmullen Booth Rd Bldg B, Clearwater, FL 33761 | 2014-03-29 |
| Find all providers in zip 33761 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073156279 | Lots Care Company Inc | Assisted Living Facility | 202 Cove Ct, Clearwater, FL 33756-1728 | 2019-10-21 |
| 1538626064 | Gv Clearwater, LLC | Assisted Living Facility | 2750 Drew St, Clearwater, FL 33759-3034 | 2019-02-20 |
| 1770002651 | American Advanced Senior Care LLC | Assisted Living Facility | 2298 Bellaire Road, Clearwater, FL 33764 | 2017-09-12 |
| 1013313246 | Sunset Villa Retirement Home | Assisted Living Facility | 2308 Americus Dr, Clearwater, FL 33763-4503 | 2014-11-17 |
| 1023411246 | Heritage House Retirement Home | Assisted Living Facility | 1810 S Belcher Rd, Clearwater, FL 33764-6602 | 2014-10-01 |
| 1316352172 | Fi-highland Pines LLC | Assisted Living Facility | 1520 Jeffords St, Clearwater, FL 33756-4449 | 2014-06-30 |
| 1710302526 | Pinnacle Health Facilities Xxxii Lp | Assisted Living Facility | 440 N 4th St, Clearwater, KS 67026-9708 | 2014-03-03 |
| 1295159903 | Hillside Gardens Inc | Assisted Living Facility | 3434 Zara Way, Clearwater, FL 33761-1225 | 2014-02-17 |
| 1245654706 | Smith Health Care Properties - Clearwater | Assisted Living Facility | 2057 Edgewater Dr, Clearwater, FL 33755-1028 | 2014-02-04 |
| 1134550718 | Lovely Care Manor LLC | Assisted Living Facility | 2869 Sarah Dr, Clearwater, FL 33759-2010 | 2013-12-06 |
| Find all providers in CLEARWATER | ||||
| City | CLEARWATER |
| Zip Code | 33761 |
Please comment or provide details below to improve the information on WICKSHIRE COUNTRYSIDE OPCO LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.