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WICKSHIRE COUNTRYSIDE OPCO LLC
NPI 1750989687
Assisted Living Facility in Clearwater, FL

Active since October 13, 2020CLIA 10D2209190 · Waiver
3141 N MCMULLEN BOOTH RD, CLEARWATER, FL 33761(727) 723-7110 Get Directions Write a Review

NPPES record last updated: October 13, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Wickshire Countryside Opco Llc NPPES

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

WICKSHIRE COUNTRYSIDE OPCO LLC (NPI 1750989687), doing business as Wickshire Countryside, is a healthcare organization registered as an assisted living facility in Clearwater, Florida and active in the NPI registry since October 2020. The organization holds a CLIA Waiver certificate valid through January 11, 2027 and lists Dan O'keefe, Ceo, as its authorized official.

NPPES Registry Identity

NPI1750989687
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameWICKSHIRE COUNTRYSIDE OPCO LLC
Location Address3141 N MCMULLEN BOOTH RDClearwater, FL 33761-2035
Mailing Address750 Old Hickory BlvdBrentwood, TN 37027-4528 · (615) 942-0240
Phone(727) 723-7110
Organization SubpartNo
Authorized OfficialDan O'keefeCeo · (615) 942-0240
Enumeration DateOctober 13, 2020
NPPES CertifiedOctober 13, 2020
✔ NPI 1750989687 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
3141 N MCMULLEN BOOTH RD, Clearwater, FL 33761
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Other Names 1

Doing Business AsWickshire Countryside

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 10D2209190

Wickshire Countryside Opco LLC · Clearwater, FL
Active · expires Jan 11, 2027
CLIA Number10D2209190
Laboratory TypeAssisted Living Facility
Certificate Effective DateJanuary 12, 2025
Certificate Expiration DateJanuary 11, 2027
Laboratory DirectorAmber Monnell
Laboratory Phone(727) 723-7110
Laboratory LocationWickshire Countryside Opco LLC3141 N Mcmullen Booth Rd, Clearwater, FL 33761
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

MR. CHARLES RICHARD LEIDNER OTR
Specialist
3141 N MCMULLEN BOOTH RD
CLEARWATER, FL 33761
Pinellas County (727) 723-7735
MR. KIM ELLEN D'AMBRA OTR
Occupational Therapist
3141 N MCMULLEN BOOTH RD
CLEARWATER, FL 33761
Pinellas County (727) 723-7735
MS. BARBARA DENISE DURR P.T.A.
Physical Therapy Assistant
3141 N MCMULLEN BOOTH RD
CLEARWATER, FL 33761
Pinellas County (727) 723-7735
MS. MARSHA JANE CLANTON LPTA
Physical Therapy Assistant
3141 N MCMULLEN BOOTH RD
CLEARWATER, FL 33761
Pinellas County (727) 723-7735
COLLIERS AT COUNTRYSIDE OPCO, LLC
Assisted Living Facility
3141 N MCMULLEN BOOTH RD
CLEARWATER, FL 33761
Pinellas County (813) 447-9260
MRS. EMILY PARRIS MCDONOUGH SLP
Speech-Language Pathologist
3141 N MCMULLEN BOOTH RD
CLEARWATER, FL 33761
Pinellas County (727) 723-7735
SHARON ANN NELSON PT
Physical Therapist
3141 N MCMULLEN BOOTH RD
CLEARWATER, FL 33761
Pinellas County (727) 723-7735

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wickshire Countryside Opco LLC's NPI number?

The NPI number for Wickshire Countryside Opco LLC is 1750989687. It was assigned to this organization in the NPPES registry on October 13, 2020. The provider is doing business as Wickshire Countryside.

Where is Wickshire Countryside Opco LLC located?

Wickshire Countryside Opco LLC is located at 3141 N Mcmullen Booth Rd, Clearwater, FL 33761. The listed phone number is (727) 723-7110.

What is Wickshire Countryside Opco LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Wickshire Countryside Opco LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2209190) is associated with this NPI, valid through January 11, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wickshire Countryside Opco LLC was last updated on October 13, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.