Largo Physician Group, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

LARGO PHYSICIAN GROUP, LLC

Practice address

11371 Cortez Blvd Ste 219
Brooksville, FL 34613-5408

Phone

(352) 592-7310

NPI assigned

Sep 13, 2021

Organization subpart

Yes

Parent organization

LARGO PHYSICIAN GROUP, LLCAs reported in NPPES

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

Authorized official

Name

William Tedrick Johnson

Title

Vice President

Phone

(615) 372-3375

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

St Petersburg Family Care Center3 organizations share this tax ID, including this one

Part of

St Petersburg Family Care Center

Other organizations with this tax ID 2

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

• Largo Physician Group, LLC

  • Pediatrics Physician
  • Brooksville, FL
  • NPI 1578732889
  NPD tax ID
• St Petersburg Family Care Center

  • Family Medicine Physician
  • St Petersburg, FL
  • NPI 1093981599
  NPD tax ID

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Largo Physician Group, LLC

  • Pediatrics Physician
  • Brooksville, FL
  • NPI 1578732889
  NPPES parent name

Practitioners 3

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

• Adedimeji Victor Adepoju, MD

  • Student in an Organized Health Care Education/Training Program
  • Brooksville, FL
  • NPI 1871295501
  NPD
• Anuj Anil Bhatia, MD

  • Internal Medicine Physician
  • Brooksville, FL
  • NPI 1023696002
  NPD
• Eric Sladek, M.D.

  • Internal Medicine Physician
  • Brooksville, FL
  • NPI 1124433297
  NPD (past)

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

{
    "created_epoch": "1631491200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631491200000",
    "number": "1437828449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274692",
            "telephone_number": "615-372-5426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11371 CORTEZ BLVD STE 219",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135408",
            "telephone_number": "352-592-7310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARGO PHYSICIAN GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LARGO PHYSICIAN GROUP, LLC",
        "enumeration_date": "2021-09-13",
        "last_updated": "2021-09-13",
        "certification_date": "2021-09-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TEDRICK",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "615-372-3375"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakeside Occupational Medical Centers Inc
• Stephen Lamberjack, LMHC
• Donna Lambert, APRN
• Karen Lynette Langley, CNA
• Zoraida Laremont, DO
• Largo Physician Group, LLC
• Eddy Laroche, MD
• Andrea Latimer
• Kayce Latocha, PA-C
• Amber Lavallee, APRN

• Internal Medicine Physician in Brooksville, FL
• Providers in Brooksville, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.