Active NPI
David John Niles, DO
- Emergency Medicine Physician
- Tampa, FL
National Provider Identifier
1295777340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- OS5288
- Practice address
- 3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307 - Phone
- (813) 870-4000
- NPI assigned
- Jun 12, 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | OS5288 | FL | Primary |
Addresses
Primary practice location
3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Mailing address
PO Box 10030
Daytona Beach, FL 32120-0030
Phone (386) 274-7800
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 044826500 | Medicaid | FL | |
| 80155 | Other | FL | BLUE CROSS OF FLORIDA |
| 207163 | Other | FL | AMERIGROUP |
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
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5288 | FL | MD | Professional Counselor |
| OS5288 | FL | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baxley Emergency Physicians LLC | Emergency Medicine | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- New Port Richey, FL
- NPI 1538118484
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1249257600000",
"number": "1295777340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10030",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "321200030",
"telephone_number": "386-274-7800",
"fax_number": "386-274-7801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3001 W DR MARTIN LUTHER KING JR BLVD",
"city": "TAMPA",
"state": "FL",
"postal_code": "336076307",
"telephone_number": "813-870-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NILES",
"first_name": "DAVID",
"middle_name": "JOHN",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2009-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "FL",
"license": "OS5288",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "044826500",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF FLORIDA",
"identifier": "80155",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "207163",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.