Phoenix Virtual Telehealth Incorporated

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

PHOENIX VIRTUAL TELEHEALTH INCORPORATED

Practice address

7901 4TH Street N, Ste 300
C/O Registered Agents Inc
St Petersburg, FL 33702-4399

Phone

(321) 222-9287

Fax

(830) 255-5842

NPI assigned

Jun 21, 2020

Organization subpart

No

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

Authorized official

Name

Stephanie Flood, PA-CNPI 1134174600

Title

President

Phone

(321) 222-9287

Specialties & licenses 1

Addresses

Practitioners 1

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

• Stephanie M Flood, PA-C

  • Physician Assistant
  • St Petersburg, FL
  • NPI 1134174600
  NPD Authorized official

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

{
    "created_epoch": "1592697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592697600000",
    "number": "1073139523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 974",
            "city": "HURLEY",
            "state": "MS",
            "postal_code": "395550974",
            "telephone_number": "321-222-9287",
            "fax_number": "830-255-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 4TH STREET N, STE 300",
            "address_2": "C/O REGISTERED AGENTS INC",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337024399",
            "telephone_number": "321-222-9287",
            "fax_number": "830-255-5842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX VIRTUAL TELEHEALTH INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-21",
        "last_updated": "2020-06-21",
        "certification_date": "2020-06-21",
        "status": "A",
        "authorized_official_last_name": "FLOOD",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "321-222-9287",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Phillips
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• Physician Assistant in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.