Organization Active NPI

I V S Nath MD FRCP PA

  • Gastroenterology Physician
  • Pinellas Park, FL
National Provider Identifier
1508199969
Registry record updated Dec 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME47362 Issued in FL
Legal business name
I V S NATH MD FRCP PA
Practice address
6217 66TH St
Pinellas Park, FL 33781-5025
Phone
(727) 546-1680
Fax
(727) 546-9746
NPI assigned
Sep 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2010

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

Authorized official

Name
Iyyuni V S Nath, MD
Title
Owner
Phone
(727) 546-1680

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X ME47362 FL Primary

Addresses

Primary practice location

6217 66TH St
Pinellas Park, FL 33781-5025

Mailing address

PO Box 25233
Tampa, FL 33622-5233
Phone (727) 823-2188

Other identifiers 1

IdentifierTypeStateIssuer
065241500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101203000662 FL Part B Supplier - Clinic/Group Practice 9032306014 Receives reassigned benefits from 1 practitioner
Practice locations: Pinellas Park, FL

National Provider Directory

National Provider Directory

Locations

6217 66th St N
Pinellas Park, FL 33781
Phone (727) 546-1680

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291939200000",
    "number": "1508199969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25233",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336225233",
            "telephone_number": "727-823-2188",
            "fax_number": "727-828-0723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6217 66TH ST",
            "city": "PINELLAS PARK",
            "state": "FL",
            "postal_code": "337815025",
            "telephone_number": "727-546-1680",
            "fax_number": "727-546-9746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I V S NATH MD FRCP PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-16",
        "last_updated": "2010-12-10",
        "status": "A",
        "authorized_official_last_name": "NATH",
        "authorized_official_first_name": "IYYUNI",
        "authorized_official_middle_name": "V S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-546-1680",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME47362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065241500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinellas Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.