Stephanie Coombs, PA-C – Physician Assistant

Key facts

NPI: 1033608443
Entity type: Individual (NPI type 1)
Primary specialty: Physician Assistant 363A00000X
License: 9111229 (FL)
Practice address: 1301 2ND Ave SW Ste 315
Largo, FL 33770-3120
Phone: (727) 587-7120
NPI assigned: May 2, 2018
Sex: Female
Sole proprietor: No

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): Yes
Credentials: Physician Assistant

State licenses

License	State	Type	Specialty
9111229	FL	MD	Physician Assistant

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Medical Physician Assistant	363AM0700X	9111229	FL
Physician Assistant	363A00000X	9111229	FL	Yes

Addresses

Primary practice location

1301 2ND Ave SW Ste 315
Largo, FL 33770-3120

Mailing address

1301 2ND Ave SW Ste 315
Largo, FL 33770-3120
Phone (727) 587-7120

Other names

Stephanie Walk Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 13, 2019.

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1033608443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 2ND AVE SW STE 315",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703120",
            "telephone_number": "727-587-7120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 2ND AVE SW STE 315",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703120",
            "telephone_number": "727-587-7120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOMBS",
        "first_name": "STEPHANIE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-02",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "9111229",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "9111229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "WALK",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Largo, FL

All providers in Largo, FL · Physician Assistant in Florida

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 13, 2019. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.