Active NPI
Ivy R Daley, MD
- Rheumatology Physician
- St Petersburg, FL
National Provider Identifier
1326676404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- ME159778
- Practice address
- 700 6TH St S FL 2
St Petersburg, FL 33701-4815 - Phone
- (727) 893-6940
- Fax
- (727) 893-6941
- NPI assigned
- Apr 1, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | ME159778 | FL | Primary |
| Internal Medicine Physician | 207R00000X | ME159778 | DC | |
| General Practice Physician | 208D00000X | ME159778 | FL |
Addresses
Primary practice location
700 6TH St S FL 2
St Petersburg, FL 33701-4815
Mailing address
9330 State Road 54
Trinity, FL 34655-1808
Phone (727) 834-4868
Other practice location 1
9330 State Road 54
Trinity, FL 34655-1808
Phone (727) 834-4868
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 132063800 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL, VI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME159778 | DC | MD | Internal Medicine Physician |
| ME159778 | FL | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Governor Juan F. Luis Hospital & Medical Center | Current | Accepting new patients | |
| Governor Juan F. Luis Hospital & Medical Center | Current | Accepting new patients |
Locations
4007 Estate Diamond Ruby
St Croix, VI 00820
Phone (340) 772-7423
Interoperability endpoints
- ivy.daley.1@22378.direct.athenahealth.com
Organizations & group practices 2
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.
-
- General Acute Care Hospital
- Christiansted, St. Croix, VI
- NPI 1972503647
-
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- St Croix, VI
- NPI 1740238534
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788393600000",
"number": "1326676404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9330 STATE ROAD 54",
"city": "TRINITY",
"state": "FL",
"postal_code": "346551808",
"telephone_number": "727-834-4868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 6TH ST S FL 2",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337014815",
"telephone_number": "727-893-6940",
"fax_number": "727-893-6941"
}
],
"practiceLocations": [
{
"address_1": "9330 State Road 54",
"address_purpose": "LOCATION",
"city": "Trinity",
"state": "FL",
"postal_code": "346551808",
"country_code": "US",
"telephone_number": "727-834-4868",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DALEY",
"first_name": "IVY",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-01",
"last_updated": "2026-09-03",
"certification_date": "2026-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "FL",
"license": "ME159778",
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "DC",
"license": "ME159778",
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "ME159778",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "132063800",
"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 Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.