NPIMap

Organization Active NPI

St Anthony's Primary Care LLC

  • Sports Medicine (Family Medicine) Physician
  • St Petersburg, FL
National Provider Identifier
1235398058
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
ME89948 Issued in FL
Legal business name
ST ANTHONY'S PRIMARY CARE LLC
Practice address
116 1St St N
St Petersburg, FL 33701-3305
Phone
(727) 895-5210
Fax
(727) 821-4297
NPI assigned
Jun 6, 2008
Organization subpart
Yes
Parent organization
ST ANTHONY'S PRIMARY CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Dr. Teresa Bradley, MD
Title
President
Phone
(727) 532-1355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X ME89948 FL Primary

Addresses

Primary practice location

116 1St St N
St Petersburg, FL 33701-3305

Mailing address

PO Box 1830
Clearwater, FL 33757-1830
Phone (727) 532-0002

National Provider Directory

National Provider Directory
Part of
Fifth Avenue Medicine

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/00f37c04-43c3-4ddc-ac68-d7a0479d717b/

Ownership & related parties

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.

Practitioners & affiliated clinicians

Practitioners 9

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": "1212710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1235398058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1830",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337571830",
            "telephone_number": "727-532-0002",
            "fax_number": "727-532-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 1ST ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013305",
            "telephone_number": "727-895-5210",
            "fax_number": "727-821-4297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ANTHONY'S PRIMARY CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST  ANTHONY'S PRIMARY CARE LLC",
        "enumeration_date": "2008-06-06",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "TERESA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-532-1355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME89948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 3, 2008; 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.