Organization Active NPI

James M Light MD PA

  • Medical Specialty Clinic/Center
  • St Petersburg, FL
National Provider Identifier
1619112208
Registry record updated Dec 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
ME0025779 Issued in FL
Legal business name
JAMES M LIGHT MD PA
Practice address
2299 9TH Ave N
Suite1 a
St Petersburg, FL 33713-6800
Phone
(727) 989-4458
Fax
(727) 321-7918
NPI assigned
Dec 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2008

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

Authorized official

Name
Dr. James M Light, MD
Title
President
Phone
(727) 522-4485

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X ME0025779 FL Primary

Addresses

Primary practice location

2299 9TH Ave N
Suite1 a
St Petersburg, FL 33713-6800

Mailing address

940 42ND Ave N
St Petersburg, FL 33703-4532
Phone (727) 522-4485

Other identifiers 1

IdentifierTypeStateIssuer
058195000MedicaidFL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228867200000",
    "number": "1619112208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 42ND AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337034532",
            "telephone_number": "727-522-4485",
            "fax_number": "727-520-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2299 9TH AVE N",
            "address_2": "SUITE1 A",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337136800",
            "telephone_number": "727-989-4458",
            "fax_number": "727-321-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES M LIGHT MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-10",
        "last_updated": "2008-12-10",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-522-4485",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "ME0025779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "058195000",
            "state": "FL"
        }
    ],
    "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 Dec 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.