Individual provider Active NPI

Mary Demersseman

  • Developmental Therapist
  • St Petersburg, FL
National Provider Identifier
1477713469
Registry record updated Oct 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental TherapistTaxonomy code 222Q00000X
Practice address
801 6TH St S
Dept. 7470
St Petersburg, FL 33701-4816
Phone
(727) 834-5439
Fax
(727) 834-5421
NPI assigned
Jun 12, 2008
Last updated
Oct 2, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X Primary

Addresses

Primary practice location

801 6TH St S
Dept. 7470
St Petersburg, FL 33701-4816

Mailing address

9212 Green Pines Ter
New Port Richey, FL 34655-1176
Phone (727) 264-6522

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)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222905600000",
    "number": "1477713469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9212 GREEN PINES TER",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346551176",
            "telephone_number": "727-264-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 6TH ST S",
            "address_2": "DEPT. 7470",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014816",
            "telephone_number": "727-834-5439",
            "fax_number": "727-834-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMERSSEMAN",
        "first_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2008-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "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 Oct 2, 2008; 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.