Organization Active NPI

James N Endicott MD PA

  • Specialist
  • St Petersburg, FL
National Provider Identifier
1811274210
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME13593 Issued in FL
Legal business name
JAMES N ENDICOTT MD PA
Practice address
555 4TH Ave S
Saint Petersburg, FL 33701-4428
Phone
(727) 551-0800
Fax
(727) 551-0801
NPI assigned
Nov 14, 2011
Last updated
Nov 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Authorized official

Name
Dr. James N Endicott, MDNPI 1295775526
Title
Ceo
Phone
(727) 551-0800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME13593 FL Primary

Addresses

Primary practice location

555 4TH Ave S
Saint Petersburg, FL 33701-4428

Mailing address

555 4TH Ave S
Saint Petersburg, FL 33701-4428
Phone (727) 551-0800

Other identifiers 1

IdentifierTypeStateIssuer
0394645MedicaidFL

National Provider Directory

National Provider Directory

Locations

555 4th Ave S
St Petersburg, FL 33701
Phone (727) 551-0800

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321228800000",
    "number": "1811274210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 4TH AVE S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337014428",
            "telephone_number": "727-551-0800",
            "fax_number": "727-551-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 4TH AVE S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337014428",
            "telephone_number": "727-551-0800",
            "fax_number": "727-551-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES N ENDICOTT MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2011-11-14",
        "status": "A",
        "authorized_official_last_name": "ENDICOTT",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "727-551-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME13593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0394645",
            "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 Nov 14, 2011; 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.