Organization Active NPI

Nephrology Consultants of Pinellas LLC

  • Specialist
  • Clearwater, FL
National Provider Identifier
1003837337
Registry record updated Mar 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0034568 Issued in FL
Legal business name
NEPHROLOGY CONSULTANTS OF PINELLAS LLC
Practice address
617 Lakeview Rd
Suite C
Clearwater, FL 33756-3338
Phone
(727) 441-3724
Fax
(727) 442-2594
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2012

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

Authorized official

Name
Dr. Frederick L Dewberry, MD
Title
Owner/President
Phone
(727) 441-3724

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME0034568 FL Primary

Addresses

Primary practice location

617 Lakeview Rd
Suite C
Clearwater, FL 33756-3338

Mailing address

617 Lakeview Rd
Suite C
Clearwater, FL 33756-3338
Phone (727) 441-3724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040823000839 FL Part B Supplier - Clinic/Group Practice 3274507546 Receives reassigned benefits from 2 practitioners
Practice locations: Clearwater, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2099105Nephrology Consultants of Pinellas617 Lakeview Rd Ste C, Clearwater, FL 33756Certificate of waiverJul 20, 2027

National Provider Directory

National Provider Directory

Locations

1840 Mease Dr
Ste 407A
Safety Harbor, FL 34695
Phone (727) 712-0980

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331683200000",
    "number": "1003837337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 LAKEVIEW RD",
            "address_2": "SUITE C",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563338",
            "telephone_number": "727-441-3724",
            "fax_number": "727-442-2594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 LAKEVIEW RD",
            "address_2": "SUITE C",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563338",
            "telephone_number": "727-441-3724",
            "fax_number": "727-442-2594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY CONSULTANTS OF PINELLAS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2012-03-14",
        "status": "A",
        "authorized_official_last_name": "DEWBERRY",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "727-441-3724",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0034568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.