Terry Daniel Kober, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9105264 Issued in FL

Practice address

11260 Sullivan St
Riverview, FL 33578-2140

Phone

(813) 689-7571

Fax

(813) 654-8129

NPI assigned

Aug 7, 2012

Last updated

Sep 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Pediatric Associates of Tampa Bay, Inc

  • Pediatrics Physician
  • Riverview, FL
  • NPI 1649618299
  NPD (past)
• Rainier Emergency Physicians LLC

  • Emergency Medicine Physician
  • Plant City, FL
  • NPI 1508275447

  Physician Assistant

  NPD (past)
• Saltzman, Tanis, Pittell, Levin and Jacobson

  dba Pediatric Associates

  • Pediatrics Physician
  • Hollywood, FL
  • NPI 1639138480
  NPD (past)
• Saltzman, Tanis, Pittell, Levin and Jacobson, LLC

  dba Pediatric Associates

  • Pediatrics Physician
  • Riverview, FL
  • NPI 1437925609
  NPD (past)

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1720335904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 S PINE ISLAND RD",
            "address_2": "SUITE 800",
            "city": "PLANTATION",
            "state": "FL",
            "postal_code": "333243920",
            "telephone_number": "813-689-7571",
            "fax_number": "813-654-8129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11260 SULLIVAN ST",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335782140",
            "telephone_number": "813-689-7571",
            "fax_number": "813-654-8129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBER",
        "first_name": "TERRY",
        "middle_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-07",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "1440",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "013091300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1440",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K099660",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA9105264",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "terry.kober@pedsassoc.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "11260 Sullivan St",
            "city": "Riverview",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335782140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevin Leslie Klein, D.O.
• Myla Elizabeth Klersy
• Erica Renee' Knight, RCSWI
• Sarah Knodle
• Knytec, Inc.
• Amanda R Koch, RBT
• Clara Kohl
• Dayaker Kokku, MD
• Peter Allen Kosoff, MD
• Edina Gale Kossow, ECHOCARDIOGRAPHER

• Physician Assistant in Riverview, FL
• Providers in Riverview, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.