NPIMap

Organization Active NPI

Heal Precisely of Northside LLC

  • General Practice Physician
  • St Petersburg, FL
National Provider Identifier
1093433674
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
HEAL PRECISELY OF NORTHSIDE LLC
Practice address
5880 49TH St N Ste N201
St Petersburg, FL 33709-2150
Phone
(727) 300-0405
NPI assigned
Aug 18, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Authorized official

Name
Mark Greer
Title
Owner
Phone
(727) 300-0405

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Primary Care Clinic/Center 261QP2300X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

5880 49TH St N Ste N201
St Petersburg, FL 33709-2150

Mailing address

5880 49TH St N Ste N201
St Petersburg, FL 33709-2150
Phone (727) 300-0405

Other practice location 1

5880 49th St N Ste N201
St Petersburg, FL 33709-2150
Phone (727) 677-9540

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220922000091 FL Part B Supplier - Clinic/Group Practice 9537544853 Receives reassigned benefits from 25 practitioners
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

5880 49th St N
Ste N201
St Petersburg, FL 33709
Phone (727) 300-0405

Practitioners & affiliated clinicians

Practitioners 25

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

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724803200000",
    "number": "1093433674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 49TH ST N STE N201",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337092150",
            "telephone_number": "727-300-0405",
            "fax_number": "855-552-3776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 49TH ST N STE N201",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337092150",
            "telephone_number": "727-300-0405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5880 49th St N Ste N201",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337092150",
            "country_code": "US",
            "telephone_number": "727-677-9540",
            "fax_number": "855-552-3776",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEAL PRECISELY OF NORTHSIDE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-18",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A",
        "authorized_official_last_name": "GREER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-300-0405"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.