Purposely Evolving

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PURPOSELY EVOLVING

Practice address

1810 S Pinellas Ave Ste B
Tarpon Springs, FL 34689-1989

Phone

(727) 937-6060

Fax

(727) 937-6030

NPI assigned

Jan 23, 2023

Organization subpart

No

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

Authorized official

Name

Dominique Paschal, APRNNPI 1083178040

Title

Owner

Phone

(727) 937-6060

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Purposely Evolving Medical Clinic Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Dominique Paschal, APRN

  • Family Nurse Practitioner
  • Tarpon Springs, FL
  • NPI 1083178040

  Primary Care

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691539200000",
    "number": "1609582782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1810 S PINELLAS AVE STE B",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346891989",
            "telephone_number": "727-937-6060",
            "fax_number": "727-937-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1810 S PINELLAS AVE STE B",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346891989",
            "telephone_number": "727-937-6060",
            "fax_number": "727-937-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURPOSELY EVOLVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A",
        "authorized_official_last_name": "PASCHAL",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-937-6060",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1083178040",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1013086917",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpc.health@purposelhyevolving.org",
            "affiliation": "N",
            "address_1": "1810 S Pinellas Ave Ste B",
            "city": "Tarpon Springs",
            "state": "FL",
            "country_code": "US",
            "postal_code": "346891989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Purposely Evolving Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Purposely Evolving Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Precision Optical PA
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• Persis Celina Puello, MD
• Jordan Zachary Pulliam, BS
• Michael Quiles Colon, D.C.
• R. Brian Williams, DO, PA
• Nina Race, RMHCI
• Jermaine Compton Ralph, M.D.
• Suriah Ramnarain, PA-C

• Primary Care Clinic/Center in Tarpon Springs, FL
• Providers in Tarpon Springs, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.