St.John's Medical Clinic,PA

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

ME41425 Issued in FL

Legal business name

ST.JOHN'S MEDICAL CLINIC,PA

Practice address

12001 N Nebraska Ave
Tampa, FL 33612-5343

Phone

(813) 972-1282

Fax

(813) 978-1677

NPI assigned

Oct 22, 2010

Last updated

Oct 22, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. CHI-Shang Chen, M.D

Title

Owner

Phone

(813) 972-1282

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1508166786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12001 N NEBRASKA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336125343",
            "telephone_number": "813-972-1282",
            "fax_number": "813-978-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12001 N NEBRASKA AVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336125343",
            "telephone_number": "813-972-1282",
            "fax_number": "813-978-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST.JOHN'S MEDICAL CLINIC,PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "CHI-SHANG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-972-1282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME41425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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.