Individual provider Active NPI

Stephen T. Gerrish, MD

  • Gastroenterology Physician
  • Tampa, FL
National Provider Identifier
1639369226
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
ME 102564 Issued in FL
Practice address
2605 W Swann Ave
Suite 600
Tampa, FL 33609-4039
Phone
(813) 876-7073
Fax
(813) 877-1277
NPI assigned
Jul 30, 2007
Last updated
Feb 17, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X ME 102564 FL Primary
Hepatology Physician 207RI0008X MD.200507 LA

Addresses

Primary practice location

2605 W Swann Ave
Suite 600
Tampa, FL 33609-4039

Mailing address

2605 W Swann Ave
Suite 600
Tampa, FL 33609-4039
Phone (813) 876-7073

Other identifiers 2

IdentifierTypeStateIssuer
09588574MedicaidMS
1049981MedicaidLA

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090210000336 FL Practitioner - GastroenterologyPractitioner - Internal Medicine 1153495502 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME 102564FLMDGastroenterology Physician
MD.200507LAMDHepatology Physician

Organizations & group practices 1

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": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329436800000",
    "number": "1639369226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2605 W SWANN AVE",
            "address_2": "SUITE 600",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094039",
            "telephone_number": "813-876-7073",
            "fax_number": "813-877-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2605 W SWANN AVE",
            "address_2": "SUITE 600",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094039",
            "telephone_number": "813-876-7073",
            "fax_number": "813-877-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERRISH",
        "first_name": "STEPHEN",
        "middle_name": "T.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-30",
        "last_updated": "2012-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME 102564",
            "primary": true
        },
        {
            "code": "207RI0008X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hepatology",
            "state": "LA",
            "license": "MD.200507",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09588574",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1049981",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.