NPIMap

Organization Active NPI

St Anthony's Primary Care LLC

  • Family Medicine Physician
  • Clearwater, FL
National Provider Identifier
1629029897
Registry record updated Jun 16, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ST ANTHONY'S PRIMARY CARE LLC
Practice address
300 Park Place Blvd
Suite 170
Clearwater, FL 33759-4932
Phone
(727) 532-1355
Fax
(727) 266-4928
NPI assigned
May 13, 2006
Last updated
Jun 16, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2015

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

Authorized official

Name
Mr. Kevin L. Corrigan
Title
Cao
Phone
(727) 532-1355

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary
Internal Medicine Physician 207R00000X NU

Addresses

Primary practice location

300 Park Place Blvd
Suite 170
Clearwater, FL 33759-4932

Mailing address

PO Box 1830
Clearwater, FL 33757-1830
Phone (727) 532-0002

Other identifiers 2

IdentifierTypeStateIssuer
276113100MedicaidFL
DE6358OtherFLRAILROAD MEDICARE NUMBER

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

300 Park Place Blvd
Ste 170
Clearwater, FL 33759

2525 Pasadena Ave S
Ste U
South Pasadena, FL 33707
Phone (727) 360-1784

1700 66th St N
Ste 403
St Petersburg, FL 33710
Phone (727) 344-2355

3301 66th St N
St Petersburg, FL 33710
Phone (727) 344-2355

509 Jackson St N
St Petersburg, FL 33705
Phone (727) 820-7800

560 Jackson St N
Ste 301
St Petersburg, FL 33705
Phone (727) 822-9497

560 Jackson St N
Ste 302
St Petersburg, FL 33705
Phone (727) 820-7701

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 37

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.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434412800000",
    "number": "1629029897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1830",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337571830",
            "telephone_number": "727-532-0002",
            "fax_number": "727-266-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PARK PLACE BLVD",
            "address_2": "SUITE 170",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337594932",
            "telephone_number": "727-532-1355",
            "fax_number": "727-266-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST ANTHONY'S PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2015-06-16",
        "status": "A",
        "authorized_official_last_name": "CORRIGAN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CAO",
        "authorized_official_telephone_number": "727-532-1355",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276113100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "DE6358",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; 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.