NPIMap

Organization Active NPI

Digestive Diseases Associates of Tampa Bay LLC

  • Gastroenterology Physician
  • Brandon, FL
National Provider Identifier
1316057441
Registry record updated Sep 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME56348 Issued in FL
Legal business name
DIGESTIVE DISEASES ASSOCIATES OF TAMPA BAY LLC
Practice address
876 S Parsons Ave
Brandon, FL 33511-6007
Phone
(813) 653-3359
Fax
(813) 662-9639
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2008

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

Authorized official

Name
Ms. Colleen Corman
Title
Practice Administrator
Phone
(813) 653-3359

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X ME56348 FL Primary

Addresses

Primary practice location

876 S Parsons Ave
Brandon, FL 33511-6007

Mailing address

876 S Parsons Ave
Brandon, FL 33511-6007
Phone (813) 653-3359

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070817000100 FL Part B Supplier - Clinic/Group Practice 5496847683 Receives reassigned benefits from 16 practitioners
Practice locations: Brandon, FL

National Provider Directory

National Provider Directory

Locations

876 S Parsons Ave
Brandon, FL 33511
Phone (813) 653-3359

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1316057441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "876 S PARSONS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116007",
            "telephone_number": "813-653-3359",
            "fax_number": "813-662-9639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "876 S PARSONS AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116007",
            "telephone_number": "813-653-3359",
            "fax_number": "813-662-9639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIGESTIVE DISEASES ASSOCIATES OF TAMPA BAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "CORMAN",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "813-653-3359",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME56348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.