Greater Tampa Bay Physician Specialists, LLC

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

Legal business name

GREATER TAMPA BAY PHYSICIAN SPECIALISTS, LLC

Practice address

2010 59TH St W Ste 1500
Bradenton, FL 34209-4649

Phone

(941) 896-4788

NPI assigned

Jul 23, 2021

Organization subpart

Yes

Parent organization

GREATER TAMPA BAY PHYSICIAN SPECIALISTS, LLCAs reported in NPPES

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

Authorized official

Name

William Tedrick Johnson

Title

Vice President

Phone

(615) 372-3375

Specialties & licenses 1

Addresses

Tax ID family

Greater Tampa Bay Physician2 organizations share this tax ID, including this one

Part of

Greater Tampa Bay Physician

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Greater Tampa Bay Physician Specialists, LLC

  • Surgery Physician
  • Saint Petersburg, FL
  • NPI 1881364107
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Greater Tampa Bay Physician Specialists, LLC

  • Surgery Physician
  • Tampa, FL
  • NPI 1528492287
  NPPES parent name

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

{
    "created_epoch": "1626998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626998400000",
    "number": "1225601560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274692",
            "telephone_number": "615-372-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 59TH ST W STE 1500",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342094649",
            "telephone_number": "941-896-4788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER TAMPA BAY PHYSICIAN SPECIALISTS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREATER TAMPA BAY PHYSICIAN SPECIALISTS, LLC",
        "enumeration_date": "2021-07-23",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TEDRICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-372-3375"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Lynn Grathwohl, ARNP
• Frances Eileen Gratz
• Christina Ann Graves
• Great Affordable Mental Health
• Great American Assisted Living Community at Bradenton, LLC
• David Green, PA
• Misti Marie Green, LMHC, LMFT, CRC
• Tiffany Anne Green, APRN
• Barry Greenberg, D.O.M
• Greenbriar Healthcare Rehabilitation and Nursing Center

• Vascular Surgery Physician in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Vascular Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.