Countryside Birthing Place Inc

Primary specialty

Birthing Clinic/CenterTaxonomy code 261QB0400X

License

337 Issued in FL

Legal business name

COUNTRYSIDE BIRTHING PLACE INC

Practice address

3060 Jones LN
Clearwater, FL 33759-1603

Phone

(727) 796-7502

Fax

(727) 796-7072

NPI assigned

Aug 22, 2006

Last updated

Jul 29, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shirley J Tregillus, LMNPI 1477686384

Title

Owner/Operator

Phone

(727) 796-7502

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Shirley J. Tregillus, LM

  • Lay Midwife
  • Clearwater, FL
  • NPI 1477686384
  NPD (past) Authorized official

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406592000000",
    "number": "1750497830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 JONES LN",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337591603",
            "telephone_number": "727-796-7502",
            "fax_number": "727-796-7072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 JONES LN",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337591603",
            "telephone_number": "727-796-7502",
            "fax_number": "727-796-7072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRYSIDE BIRTHING PLACE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2014-07-29",
        "status": "A",
        "authorized_official_last_name": "TREGILLUS",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "727-796-7502",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LM"
    },
    "taxonomies": [
        {
            "code": "261QB0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Birthing",
            "state": "FL",
            "license": "337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011140400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Countryside Hearing Aid Services, Inc
• Countryside Mall Dental PA
• Countryside Neurology Inc

• Birthing Clinic/Center in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Birthing Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.