Active NPI
Center for Digestive Diseases PA
- Gastroenterology Physician
- St Petersburg, FL
National Provider Identifier
1619900248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- ME48637
- Legal business name
- CENTER FOR DIGESTIVE DISEASES PA
- Practice address
- 1609 Pasadena Ave S
Ste 3M
St Petersburg, FL 33707-4563 - Phone
- (727) 384-2016
- Fax
- (727) 343-3791
- NPI assigned
- Jul 8, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Kathy F Jackson
- Title
- Schedule Coornidator
- Phone
- (727) 384-2016
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | ME48637 | FL | Primary |
Addresses
Primary practice location
1609 Pasadena Ave S
Ste 3M
St Petersburg, FL 33707-4563
Mailing address
PO Box 20267
Tampa, FL 33622-0267
Phone (727) 823-2188
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24038 | Other | FL | BCBS |
| CL1357 | Other | FL | RAILROAD MEDICARE |
| 373745400 | Medicaid | FL |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Gastroenterology Physician
- St Petersburg, FL
- NPI 1851352462
-
- Adult Health Nurse Practitioner
- St Petersburg, FL
- NPI 1477794741
-
- Internal Medicine Physician
- Westbrook, CT
- NPI 1659396737
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152316800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1245283200000",
"number": "1619900248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 20267",
"city": "TAMPA",
"state": "FL",
"postal_code": "336220267",
"telephone_number": "727-823-2188",
"fax_number": "727-828-0723"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1609 PASADENA AVE S",
"address_2": "STE 3M",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337074563",
"telephone_number": "727-384-2016",
"fax_number": "727-343-3791"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CENTER FOR DIGESTIVE DISEASES PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-08",
"last_updated": "2009-06-18",
"status": "A",
"authorized_official_last_name": "JACKSON",
"authorized_official_first_name": "KATHY",
"authorized_official_middle_name": "F",
"authorized_official_title_or_position": "SCHEDULE COORNIDATOR",
"authorized_official_telephone_number": "727-384-2016",
"authorized_official_name_prefix": "Ms."
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": "FL",
"license": "ME48637",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "24038",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CL1357",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "373745400",
"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 Jun 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.