NPIMap

Organization Active NPI

MPM Cardiology Services LLC

  • Cardiovascular Disease Physician
  • Clearwater, FL
National Provider Identifier
1114295698
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MPM CARDIOLOGY SERVICES LLC
Practice address
300 Park Place Blvd
Suite 170
Clearwater, FL 33759-4932
Phone
(727) 532-0002
Fax
(727) 266-4928
NPI assigned
Dec 12, 2011
Last updated
Jun 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Authorized official

Name
Mr. Glenn D. Waters
Title
President
Phone
(727) 532-1355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

300 Park Place Blvd
Suite 170
Clearwater, FL 33759-4932

Mailing address

PO Box 9200
Palm Harbor, FL 34682-9200
Phone (727) 789-3179

Other identifiers 1

IdentifierTypeStateIssuer
008209100MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1323648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1114295698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9200",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346829200",
            "telephone_number": "727-789-3179",
            "fax_number": "727-781-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PARK PLACE BLVD",
            "address_2": "SUITE 170",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337594932",
            "telephone_number": "727-532-0002",
            "fax_number": "727-266-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MPM CARDIOLOGY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-12",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-532-1355",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008209100",
            "state": "FL"
        }
    ],
    "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 Jun 16, 2015; 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.