Organization Active NPI

Gulf Coast Family Wellness LLC

  • Family Nurse Practitioner
  • St Petersburg, FL
National Provider Identifier
1568056117
Registry record updated May 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
GULF COAST FAMILY WELLNESS LLC
Practice address
7855 38TH Ave N Ste 200
St Petersburg, FL 33710-1134
Phone
(727) 480-0387
NPI assigned
Feb 24, 2021
Last updated
May 4, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2021

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

Authorized official

Name
Stephanie Anderson, APRNNPI 1114386661
Title
Owner/ Authorized Official
Phone
(727) 480-0387

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

7855 38TH Ave N Ste 200
St Petersburg, FL 33710-1134

Mailing address

PO Box 7843
Clearwater, FL 33758-7843
Phone (727) 480-0387

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D2275712Gulf Coast Family Wellness, LLC7855 38TH Ave N - Ste 200, Saint Petersburg, FL 33710Certificate of waiverJan 25, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1614124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620086400000",
    "number": "1568056117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7843",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337587843",
            "telephone_number": "727-480-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7855 38TH AVE N STE 200",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337101134",
            "telephone_number": "727-480-0387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST FAMILY WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-24",
        "last_updated": "2021-05-04",
        "certification_date": "2021-05-04",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "OWNER/ AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "727-480-0387",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "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 May 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.