Individual provider Active NPI

Ivy R Daley, MD

  • Rheumatology Physician
  • St Petersburg, FL
National Provider Identifier
1326676404
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
ME159778 Issued in FL
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

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
132063800MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230106001681 FL Practitioner - General Practice 6103296223
I20231007000416 VI Practitioner - Internal Medicine 6103296223 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME159778DCMDInternal Medicine Physician
ME159778FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Governor Juan F. Luis Hospital & Medical Center CurrentSince Sep 17, 2023 Accepting new patients
Governor Juan F. Luis Hospital & Medical Center CurrentSince Sep 17, 2023 Accepting new patients

Locations

4007 Estate Diamond Ruby
St Croix, VI 00820
Phone (340) 772-7423

Interoperability endpoints

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.