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WICKSHIRE PORT ST. LUCIE
NPI 1184222002
Assisted Living Facility in Port St Lucie, FL

Active since October 13, 2020CLIA 10D1090612 · Waiver
9825 S US HIGHWAY 1, PORT ST LUCIE, FL 34952(772) 337-0084 Get Directions Write a Review

NPPES record last updated: October 13, 2020. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Wickshire Port St. Lucie NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WICKSHIRE PORT ST. LUCIE (NPI 1184222002), doing business as Wickshire Port St Lucie, is a healthcare organization registered as an assisted living facility in Port St Lucie, Florida and active in the NPI registry since October 2020. The organization holds a CLIA Waiver certificate valid through October 14, 2026 and lists Dan O'keefe, Ceo, as its authorized official.

NPPES Registry Identity

NPI1184222002
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameWICKSHIRE PORT ST. LUCIE
Location Address9825 S US HIGHWAY 1Port St Lucie, FL 34952-5626
Mailing Address750 Old Hickory BlvdBrentwood, TN 37027-4528 · (615) 942-0240
Phone(772) 337-0084
Organization SubpartNo
Authorized OfficialDan O'keefeCeo · (615) 942-0240
Enumeration DateOctober 13, 2020
NPPES CertifiedOctober 13, 2020
✔ NPI 1184222002 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition

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.

Also ListedAlzheimer Center (Dementia Center)Taxonomy 311500000X
9825 S US HIGHWAY 1, Port St Lucie, FL 34952
Open in Google Maps ↗

Other Names 1

Doing Business AsWickshire Port St Lucie

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D1090612

Wickshire Port St Lucie Opco LLC · Port Saint Lucie, FL
Active · expires Oct 14, 2026
CLIA Number10D1090612
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 15, 2024
Certificate Expiration DateOctober 14, 2026
Laboratory DirectorMichelle Rhoades
Laboratory Phone(772) 337-0084
Laboratory LocationWickshire Port St Lucie Opco LLC9825 S Us Hwy 1, Port Saint Lucie, FL 34952
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MERRILL GARDENS PORT ST. LUCIE
Assisted Living Facility
9825 S US HIGHWAY 1
PORT ST LUCIE, FL 34952
St. Lucie County (772) 337-0084
S-H THIRTY-FIVE OPCO - PORT ST. LUCIE, LLC
Assisted Living Facility
9825 S US HIGHWAY 1
PORT ST LUCIE, FL 34952
St. Lucie County (772) 337-0084
COLLIERS AT PORT ST. LUCIE OPCO, LLC
Assisted Living Facility
9825 S US HIGHWAY 1
PORT ST LUCIE, FL 34952
St. Lucie County (772) 202-9119

Frequently Asked Questions

What is WICKSHIRE PORT ST. LUCIE's NPI number?

The NPI number assigned to this healthcare provider is 1184222002, enumerated as an "organization" on October 13, 2020.

Where is the provider located?

The provider is located at 9825 S US HIGHWAY 1 PORT ST LUCIE, FL 34952 and the phone number is (772) 337-0084.

What is the provider's specialty?

Assisted Living Facility with taxonomy code 310400000X.