Active NPI
Jacob Foshee
- Dentist
- St Petersburg, FL
National Provider Identifier
1528679180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 25325
- Practice address
- 425 22ND Ave N
Saint Petersburg, FL 33704-4345 - Phone
- (727) 498-7581
- NPI assigned
- Aug 16, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 25325 | FL | Primary |
Addresses
Primary practice location
425 22ND Ave N
Saint Petersburg, FL 33704-4345
Mailing address
5554 Spanish Moss CV
Bradenton, FL 34203-2114
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220811003969 | FL | Order and Referring Only - Dentist | 3375926140 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25325 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Klement Family Dental P.a. | Current | Accepting new patients |
Locations
425 22nd Ave N
Saint Petersburg, FL 33704
Phone (727) 498-7581
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Klement Family Dental
- General Practice Dentistry
- St Petersburg, FL
- NPI 1952932816
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660176000000",
"number": "1528679180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5554 SPANISH MOSS CV",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342032114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 22ND AVE N",
"city": "SAINT PETERSBURG",
"state": "FL",
"postal_code": "337044345",
"telephone_number": "727-498-7581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOSHEE",
"first_name": "JACOB",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-08-16",
"last_updated": "2022-08-11",
"certification_date": "2022-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "25325",
"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 Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.