Organization Active NPI

Kozhimala T. John M.D. P.a.

  • Gastroenterology Physician
  • Zephyrhills, FL
National Provider Identifier
1215206792
Registry record updated Aug 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME23148 Issued in FL
Legal business name
KOZHIMALA T. JOHN M.D. P.A.
Practice address
6340 Fort King Rd
Zephyrhills, FL 33542
Phone
(813) 782-6116
Fax
(813) 780-1051
NPI assigned
Dec 29, 2011
Last updated
Aug 22, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2018

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

Authorized official

Name
Dr. Kozhimala T John, M.D.
Title
M.D./Owner
Phone
(813) 782-6116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME23148 FL Primary

Addresses

Primary practice location

6340 Fort King Rd
Zephyrhills, FL 33542

Mailing address

PO Box 1617
Zephyrhills, FL 33539-1617
Phone (813) 782-6116

Other identifiers 3

IdentifierTypeStateIssuer
058391000MedicaidFL
51086OtherFLBC/BS
1891890638OtherFLNPI (INDIVIDUAL)

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1325116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534896000000",
    "number": "1215206792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1617",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335391617",
            "telephone_number": "813-782-6116",
            "fax_number": "813-780-1051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6340 FORT KING RD",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "33542",
            "telephone_number": "813-782-6116",
            "fax_number": "813-780-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOZHIMALA T. JOHN M.D. P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-29",
        "last_updated": "2018-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHN",
        "authorized_official_first_name": "KOZHIMALA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "M.D./OWNER",
        "authorized_official_telephone_number": "813-782-6116",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME23148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058391000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "51086",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI (INDIVIDUAL)",
            "identifier": "1891890638",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Zephyrhills, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2018; 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.