Marie S Jeoboam, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME 111875 Issued in FL

Practice address

7005 4TH St N
Suite 1
St Petersburg, FL 33702-5909

Phone

(727) 521-1524

Fax

(727) 525-7518

NPI assigned

Mar 30, 2007

Last updated

May 11, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, TX2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/3123/brand/3/csg/41/fhir/r4

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.

• Inpatient Consultants of Florida, Inc

  • Internal Medicine Physician
  • Orange Park, FL
  • NPI 1396795597
  Medicare reassignment NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  dba Northern Navajo Medical Center

  • General Acute Care Hospital
  • Shiprock, NM
  • NPI 1780639971

  TX

  Medicare reassignment NPD
• Inpatient Consultants of Florida Inc

  • Hospitalist Physician
  • Tampa, FL
  • NPI 1457511164
  NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Teec Nos Pos, AZ
  • NPI 1477615789
  NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  dba Dzilth-Na-O-Dith-Hle Health Center

  • General Acute Care Hospital
  • Bloomfield, NM
  • NPI 1760427587
  NPD
• Baycare Medical Group Pediatric Walk-in Care LLC

  • Pediatrics Physician
  • Lutz, FL
  • NPI 1861850117
  NPD (past)
• Baycare Medical Group Pediatric Walk-in, LLC

  • Pediatrics Physician
  • Tampa, FL
  • NPI 1679724488

  Family Medicine

  NPD (past)
• Bayfront Physician Specialty Service

  • Specialist
  • St Petersburg, FL
  • NPI 1841477890
  NPD (past)

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1659491769",
    "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": "727-532-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7005 4TH ST N",
            "address_2": "SUITE 1",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337025909",
            "telephone_number": "727-521-1524",
            "fax_number": "727-525-7518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEOBOAM",
        "first_name": "MARIE",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME 111875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erik Jensen, RBT
• Kenneth Andrew Jensen
• Preceousa Serna Jensen, DO, PMH
• Summer Jensen, OTRL
• Brenda L Jensis
• Linda Jeremiah
• Christopher Jermyn
• Jernigan Rehabilitative Services, Inc.
• Cara Rose Jernigan, MMT, MT-BC
• Jason Paul Jernigan, PHARM.D.

• Family Medicine Physician in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.