NPIMap

Organization Active NPI

Shilo LLC

Doing business as Shiloh Medical Group

  • Multi-Specialty Clinic/Center
  • Tampa, FL
National Provider Identifier
1477119519
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SHILO LLC
Doing business as
Shiloh Medical Group
Tampa Pain Clinic
Practice address
10549 N Florida Ave Ste J
Tampa, FL 33612-6707
Phone
(813) 252-0242
NPI assigned
May 14, 2019
Last updated
Jan 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Authorized official

Name
Stephen O Banjoko
Title
Cfo
Phone
(212) 257-0225

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

10549 N Florida Ave Ste J
Tampa, FL 33612-6707

Mailing address

PO Box 17175
Tampa, FL 33682-7175

Other names 2

  • SHILOH MEDICAL GROUP Doing business as
  • TAMPA PAIN CLINIC Doing business as

National Provider Directory

National Provider Directory

Locations

10549 N Florida Ave
Ste J
Tampa, FL 33612
Phone (813) 341-4000

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

  • Shilo LLC

    dba Tampa Suboxone Clinic

    • Substance Use Disorder Rehabilitation Clinic/Center
    • Tampa, FL
    • NPI 1437810199
    NPPES parent name

Practitioners & affiliated clinicians

Practitioners 3

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": "1557792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641340800000",
    "number": "1477119519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17175",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336827175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10549 N FLORIDA AVE STE J",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336126707",
            "telephone_number": "813-252-0242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHILO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-14",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A",
        "authorized_official_last_name": "BANJOKO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "212-257-0225"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHILOH MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SHILOH MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TAMPA PAIN CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

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