Active NPI
Medical Center on the Gulf LLC
- Internal Medicine Physician
- Palm Harbor, FL
National Provider Identifier
1497720700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- MEDICAL CENTER ON THE GULF LLC
- Practice address
- 30522 US 19 N Ste 109
Palm Harbor, FL 34684-4436 - Phone
- (727) 738-0220
- Fax
- (727) 734-7072
- NPI assigned
- Feb 21, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ananda Som, MD
- Title
- Chairman
- Phone
- (727) 738-0220
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
30522 US 19 N Ste 109
Palm Harbor, FL 34684-4436
Mailing address
PO Box 1921
Dunedin, FL 34697-1921
Phone (727) 738-0220
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110239219 | Other | RAILROAD MEDICARE | |
| K8814 | Other | GRP # | |
| P2746142 | Other | OXFORD HEALTH INSURANCE | |
| 244046 | Other | AVMED | |
| 254433400 | Medicaid | FL | |
| 410972 | Other | TUFTS HEALTH PLAN | |
| 5306646 | Other | AETNA | |
| 1627837 | Other | FIRST HEALTH | |
| 213422 | Other | AMERIGROUP | |
| 3087332 | Other | CIGNA | |
| 43705 | Other | BLUE CROSS BLUE SHIELD | |
| 0407698 | Other | UNITED HEALTHCARE |
National Provider Directory
National Provider DirectoryLocations
30522 US Highway 19 N
Ste 109
Palm Harbor, FL 34684
Phone (727) 738-0220
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1436745600000",
"number": "1497720700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1921",
"city": "DUNEDIN",
"state": "FL",
"postal_code": "346971921",
"telephone_number": "727-738-0220",
"fax_number": "727-734-7072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30522 US 19 N STE 109",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346844436",
"telephone_number": "727-738-0220",
"fax_number": "727-734-7072"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDICAL CENTER ON THE GULF LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-02-21",
"last_updated": "2015-07-13",
"status": "A",
"authorized_official_last_name": "SOM",
"authorized_official_first_name": "ANANDA",
"authorized_official_title_or_position": "CHAIRMAN",
"authorized_official_telephone_number": "727-738-0220",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "110239219",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GRP #",
"identifier": "K8814",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD HEALTH INSURANCE",
"identifier": "P2746142",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "244046",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "254433400",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "410972",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5306646",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "1627837",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "213422",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3087332",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "43705",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "0407698",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Palm Harbor, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.