NPIMap

Organization Active NPI

Pediatric Gastroenterology Hepatology & Nutrition of FL P a

  • Pediatric Gastroenterology Physician
  • St Petersburg, FL
National Provider Identifier
1780787382
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
Legal business name
PEDIATRIC GASTROENTEROLOGY HEPATOLOGY & NUTRITION OF FL P A
Practice address
601 5TH St S.
Suite #605
St Petersburg, FL 33701-4808
Phone
(727) 822-4300
Fax
(727) 456-1399
NPI assigned
Sep 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Authorized official

Name
Dr. Daniel T McClenathan, MD, MD
Title
Owner
Phone
(727) 822-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0206X Primary

Addresses

Primary practice location

601 5TH St S.
Suite #605
St Petersburg, FL 33701-4808

Mailing address

2901 58TH Ave N
St Petersburg, FL 33714-1326
Phone (727) 822-4300

Other identifiers 1

IdentifierTypeStateIssuer
254401600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050509000160 FL Part B Supplier - Clinic/Group Practice 3476593534 Receives reassigned benefits from 26 practitioners
Practice locations: Immokalee, FL; Temple Terrace, FL; Tampa, FL; St Petersburg, FL; Sarasota, FL; Safety Harbor, FL; Port Charlotte, FL; Riverview, FL…

National Provider Directory

National Provider Directory

Locations

9800 S Healthpark Dr
Ste 145
Fort Myers, FL 33908
Phone (239) 689-5100

2905 Allegra Way
Lutz, FL 33559

1265 Creekside Pkwy
Ste 200
Naples, FL 34108
Phone (239) 513-1992

18316 Murdock Cir
Unit 106
Port Charlotte, FL 33948
Phone (877) 463-5434

6710 Embassy Blvd
Port Richey, FL 34668

1840 Mease Dr
Ste 204
Safety Harbor, FL 34695
Phone (727) 791-7504

1840 Mease Dr
Ste 215
Safety Harbor, FL 34695
Phone (727) 791-7504

4040 Sawyer Rd
Sarasota, FL 34233
Phone (941) 927-4888

5881 Rand Blvd
Sarasota, FL 34238
Phone (727) 822-7344

601 5th St S
Ste 605
St Petersburg, FL 33701
Phone (727) 822-4300

2901 58th Ave N
St Petersburg, FL 33714

3003 W Mlk Blvd
Bldg 3RD
Tampa, FL 33607
Phone (813) 870-4948

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737504000000",
    "number": "1780787382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2901 58TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337141326",
            "telephone_number": "727-822-4300",
            "fax_number": "727-456-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 5TH ST S.",
            "address_2": "SUITE #605",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014808",
            "telephone_number": "727-822-4300",
            "fax_number": "727-456-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC GASTROENTEROLOGY HEPATOLOGY & NUTRITION OF FL P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2025-01-22",
        "status": "A",
        "authorized_official_last_name": "MCCLENATHAN, MD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "727-822-4300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254401600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.