NPIMap

Organization Active NPI

PMG Inpatient Services LLC

  • Family Medicine Physician
  • St Petersburg, FL
National Provider Identifier
1427899798
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PMG INPATIENT SERVICES LLC
Practice address
5101 Brittany Dr S
St Petersburg, FL 33715-1565
Phone
(279) 547-2047
NPI assigned
Jun 3, 2024
Last updated
Jun 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Authorized official

Name
Nicole Howard
Title
SVP of Administrative Services
Phone
(337) 991-9276

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

5101 Brittany Dr S
St Petersburg, FL 33715-1565

Mailing address

200 2ND Ave S # 781
St Petersburg, FL 33701-4313
Phone (727) 954-7204

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240730000032 FL Part B Supplier - Clinic/Group Practice 1254878069 Receives reassigned benefits from 6 practitioners
Practice locations: St Petersburg, FL

National Provider Directory

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": "1717372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1427899798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 2ND AVE S # 781",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014313",
            "telephone_number": "727-954-7204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 BRITTANY DR S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337151565",
            "telephone_number": "279-547-2047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PMG INPATIENT SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "SVP OF ADMINISTRATIVE SERVICES",
        "authorized_official_telephone_number": "337-991-9276"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "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 Jun 25, 2024; 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.