NPIMap

Organization Active NPI

Verimed Health Group Carrollwood, LLC

  • Internal Medicine Physician
  • Tampa, FL
National Provider Identifier
1336268788
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0076006 Issued in FL
Legal business name
VERIMED HEALTH GROUP CARROLLWOOD, LLC
Practice address
8521 N Armenia Ave
Tampa, FL 33604-2540
Phone
(813) 932-0996
Fax
(813) 932-0266
NPI assigned
Mar 28, 2007
Last updated
Jun 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Authorized official

Name
Mrs. Gina Perez
Title
Office Manager
Phone
(813) 932-0996

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0076006 FL Primary

Addresses

Primary practice location

8521 N Armenia Ave
Tampa, FL 33604-2540

Mailing address

8521 N Armenia Ave
Tampa, FL 33604-2540
Phone (813) 932-0996

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070808000366 FL Part B Supplier - Clinic/Group Practice 5890886667 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Land O Lakes, FL; Tampa, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Verimed Health Group Carrollwood LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1336268788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8521 N ARMENIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336042540",
            "telephone_number": "813-932-0996",
            "fax_number": "813-932-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8521 N ARMENIA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336042540",
            "telephone_number": "813-932-0996",
            "fax_number": "813-932-0266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERIMED HEALTH GROUP CARROLLWOOD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "813-932-0996",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "0076006",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 7, 2016; 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.