Active NPI
Thomas Flaherty, PA
- Medical Physician Assistant
- Port Charlotte, FL
National Provider Identifier
1194737528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA0002451
- Practice address
- 3390 Tamiami TRL
Suite 204
Port Charlotte, FL 33952-8157 - Phone
- (941) 391-5495
- Fax
- (941) 875-9875
- NPI assigned
- Aug 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA0002451 | FL | Primary |
Addresses
Primary practice location
3390 Tamiami TRL
Suite 204
Port Charlotte, FL 33952-8157
Mailing address
3390 Tamiami TRL
Suite 204
Port Charlotte, FL 33952-8157
Phone (941) 391-5495
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA0002451 | FL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Birgit Bodine MD PA | Past | Accepting new patients | |
| Inpatient Consultants of Florida, Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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- NPI 1396795597
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155427200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383177600000",
"number": "1194737528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3390 TAMIAMI TRL",
"address_2": "SUITE 204",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339528157",
"telephone_number": "941-391-5495",
"fax_number": "941-875-9875"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3390 TAMIAMI TRL",
"address_2": "SUITE 204",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339528157",
"telephone_number": "941-391-5495",
"fax_number": "941-875-9875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLAHERTY",
"first_name": "THOMAS",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-13",
"last_updated": "2013-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA0002451",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.