Individual provider Active NPI

Peggy Ann Cordle, ARNP-C

  • Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1578826954
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9285219 Issued in FL
Practice address
1229 S Myrtle Ave
Clearwater, FL 33756-3469
Phone
(727) 403-5380
NPI assigned
Jun 20, 2012
Last updated
May 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN9285219 FL Primary

Addresses

Primary practice location

1229 S Myrtle Ave
Clearwater, FL 33756-3469

Mailing address

420 18TH Ave
Indian Rocks Beach, FL 33785-2922
Phone (727) 560-4232

Other practice location 1

420 18th Ave
Indian Rocks Beach, FL 33785-2922
Phone (727) 403-5380

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120823000513 FL Practitioner - Nurse Practitioner 3173770310 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN9285219FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Emergency Physicians LLC CurrentSince May 17, 2014 Accepting new patients
Goodcall Housecalls, LLC CurrentSince Feb 23, 2025 Accepting new patients
Suncoast Internal Medicine Consultants, P.a. CurrentSince Jun 12, 2012 Accepting new patients
First Knight Medical Inc CurrentSince Jan 27, 2014 Accepting new patients

Locations

1229 S Myrtle Ave
Clearwater, FL 33756
Phone (727) 403-5380

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

13644 Washington Rd
Largo, FL 33774
Phone (727) 595-2519

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1578826954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 18TH AVE",
            "city": "INDIAN ROCKS BEACH",
            "state": "FL",
            "postal_code": "337852922",
            "telephone_number": "727-560-4232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 S MYRTLE AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563469",
            "telephone_number": "727-403-5380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 18th Ave",
            "address_purpose": "LOCATION",
            "city": "Indian Rocks Beach",
            "state": "FL",
            "postal_code": "337852922",
            "country_code": "US",
            "telephone_number": "727-403-5380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORDLE",
        "first_name": "PEGGY",
        "middle_name": "ANN",
        "credential": "ARNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9285219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.