Organization Active NPI

Alan Smith M.D. LLC

  • Primary Care Clinic/Center
  • St Petersburg, FL
National Provider Identifier
1194086124
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
ME0044988 Issued in FL
Legal business name
ALAN SMITH M.D. LLC
Practice address
6500 1St Ave N
St Petersburg, FL 33710-8404
Phone
(727) 343-2741
Fax
(727) 343-2814
NPI assigned
Jun 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Authorized official

Name
Victoria Smith
Title
Practice Manager
Phone
(727) 343-2741

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X ME0044988 FL Primary

Addresses

Primary practice location

6500 1St Ave N
St Petersburg, FL 33710-8404

Mailing address

6500 1St Ave N
St Petersburg, FL 33710-8404
Phone (727) 343-2741

Other identifiers 1

IdentifierTypeStateIssuer
042850700MedicaidFL

Other names 1

  • Pasadena Premier Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120626000158 FL Part B Supplier - Clinic/Group Practice 4688839616 Receives reassigned benefits from 2 practitioners
Practice locations: St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

1769 66th St N
St Petersburg, FL 33710
Phone (727) 343-2741

6500 1st Ave N
St Petersburg, FL 33710
Phone (727) 343-2741

Practitioners & affiliated clinicians

Practitioners 2

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": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778112000000",
    "number": "1194086124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 1ST AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337108404",
            "telephone_number": "727-343-2741",
            "fax_number": "727-343-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 1ST AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337108404",
            "telephone_number": "727-343-2741",
            "fax_number": "727-343-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALAN SMITH M.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "727-343-2741"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "ME0044988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "042850700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pasadena Premier Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 7, 2026; 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.