Tannelle McDougle, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA9107285 Issued in FL

Practice address

4260 Central Ave
St Petersburg, FL 33711-1140

Phone

(727) 339-5496

Fax

(727) 361-6247

NPI assigned

Jun 27, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tannelle Clarke Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2024 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: tannelle.clarke@158603205410820.direct.elationemr.com

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.

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  Physician Assistant

  NPD (past)
• Brodrick ER SVCS Partnership LLC

  • Emergency Medicine Physician
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  • NPI 1467400796
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• Florida Em-I Medical Services PA

  • Emergency Medicine Physician
  • St Petersburg, FL
  • NPI 1871542837
  NPD (past)
• Sunshine City Emergency Physicians

  • Emergency Medicine Physician
  • St. Petersburg, FL
  • NPI 1770533143
  NPD (past)

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

{
    "created_epoch": "1372291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1407296197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4260 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337111140",
            "telephone_number": "727-339-5496",
            "fax_number": "727-361-6247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4260 CENTRAL AVE",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337111140",
            "telephone_number": "727-339-5496",
            "fax_number": "727-361-6247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOUGLE",
        "first_name": "TANNELLE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-27",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PA9107285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TANNELLE",
            "last_name": "CLARKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bernadette Marie McDonald, ARNP
• Kelly McDonnell, M.S., SLP
• Emily A McDonough
• Sandra McDonough, MS, CGC, LGC
• Eric McDougle, P.A.
• Darrell McDuffie, PHARM.D.
• Kate McEwan
• Sean Michael McGarvey, MD
• Julie McGary, MSW
• Melissa McGee

• Medical Physician Assistant in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Medical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.