Individual provider Active NPI

Perry Boyd Everett, M.D.

  • Pediatric Critical Care Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1295777506
Registry record updated Feb 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
ME46899 Issued in FL
Practice address
1033 Dr Martin Luther King Jr St N
Suite 108
St Petersburg, FL 33701-1547
Phone
(727) 456-4250
Fax
(727) 346-1044
NPI assigned
Jun 12, 2006
Last updated
Feb 3, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X ME46899 FL Primary

Addresses

Primary practice location

1033 Dr Martin Luther King Jr St N
Suite 108
St Petersburg, FL 33701-1547

Mailing address

1033 Dr Martin Luther King Jr St N
Suite 108
St Petersburg, FL 33701-1547
Phone (727) 456-4250

Other identifiers 1

IdentifierTypeStateIssuer
041718100MedicaidFL

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 Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins All Children's Hospital, Inc 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1265155200000",
    "number": "1295777506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1033 DR MARTIN LUTHER KING JR ST N",
            "address_2": "SUITE 108",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337011547",
            "telephone_number": "727-456-4250",
            "fax_number": "727-346-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1033 DR MARTIN LUTHER KING JR ST N",
            "address_2": "SUITE 108",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337011547",
            "telephone_number": "727-456-4250",
            "fax_number": "727-346-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERETT",
        "first_name": "PERRY",
        "middle_name": "BOYD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2010-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "FL",
            "license": "ME46899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041718100",
            "state": "FL"
        }
    ],
    "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 Feb 3, 2010; 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.