Images Medical Clinic PA

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

IMAGES MEDICAL CLINIC PA

Practice address

38176 Medical Center Ave
Zephyrhills, FL 33540-1380

Phone

(813) 444-7311

Fax

(813) 488-0011

NPI assigned

Nov 20, 2020

Organization subpart

No

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

Authorized official

Name

Kasie Russell, APRNNPI 1366629123

Title

Owner

Phone

(813) 444-7311

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/FECIDD

Practitioners 1

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

• Kasie L Russell, ARNP

  • Adult Health Nurse Practitioner
  • Zephyrhills, FL
  • NPI 1366629123
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1386247310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7062",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335450100",
            "telephone_number": "813-444-7311",
            "fax_number": "813-488-0011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38176 MEDICAL CENTER AVE",
            "city": "ZEPHYRHILLS",
            "state": "FL",
            "postal_code": "335401380",
            "telephone_number": "813-444-7311",
            "fax_number": "813-488-0011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGES MEDICAL CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-20",
        "last_updated": "2023-03-07",
        "certification_date": "2020-12-24",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KASIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-444-7311",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN",
            "identifier": "9268544",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Adult Health Nurse Practitioner in Zephyrhills, FL
• Providers in Zephyrhills, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.