Individual provider Active NPI

Mary Kathryn Parham, FNP, PMHNP, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1407980568
Registry record updated Nov 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN9214558 Issued in FL
Practice address
9800 4TH St N Ste 200
Saint Petersburg, FL 33702-2462
Phone
(727) 266-8895
Fax
(833) 563-0460
NPI assigned
Mar 14, 2007
Last updated
Nov 5, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN9214558 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X AP8361 AZ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN9214558 FL Primary

Addresses

Primary practice location

9800 4TH St N Ste 200
Saint Petersburg, FL 33702-2462

Mailing address

9800 4TH St N Ste 200
St Petersburg, FL 33702-2462
Phone (727) 266-8895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9214558FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Health Care Services, Inc. Psychiatric/Mental Health CurrentSince Aug 13, 2001 Accepting new patients
Kreider Chiropractic Inc Past Accepting new patients
Aldrich Cardiovascular Institute PastSince Oct 29, 2018 Accepting new patients
Take Care Health Services PA Family Past Accepting new patients

Locations

2055 Wood St
Ste 220
Sarasota, FL 34237
Phone (941) 366-6611

153 Center Rd
Venice, FL 34285
Phone (941) 408-8988

Interoperability endpoints

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

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667606400000",
    "number": "1407980568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 4TH ST N STE 200",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337022462",
            "telephone_number": "727-266-8895",
            "fax_number": "833-563-0460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 4TH ST N STE 200",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337022462",
            "telephone_number": "727-266-8895",
            "fax_number": "833-563-0460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARHAM",
        "first_name": "MARY",
        "middle_name": "KATHRYN",
        "name_prefix": "Miss",
        "credential": "FNP, PMHNP, APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2022-11-05",
        "certification_date": "2020-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN9214558",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "AP8361",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9214558",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.