NPIMap

Organization Active NPI

SC Physicians LLC

  • Multi-Specialty Clinic/Center
  • St Petersburg, FL
National Provider Identifier
1811295454
Registry record updated Jan 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SC PHYSICIANS LLC
Practice address
620 10TH Street N
St Petersburg, FL 33705-1407
Phone
(727) 532-1355
Fax
(727) 266-4928
NPI assigned
Mar 7, 2011
Last updated
Jan 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2018

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

Authorized official

Name
Ms. Lynda A. Gorken
Title
VP, PFS
Phone
(727) 532-1355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

620 10TH Street N
St Petersburg, FL 33705-1407

Mailing address

PO Box 12868
St Petersburg, FL 33733-2868
Phone (727) 532-0002

Other identifiers 1

IdentifierTypeStateIssuer
003689300MedicaidFL

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

620 10th St N
Ste 1E
St Petersburg, FL 33705
Phone (727) 824-3120

620 10th St N
Ste 3D
St Petersburg, FL 33705
Phone (727) 824-7146

7477 Martin Luther King St N
St Petersburg, FL 33702
Phone (727) 521-2424

Ownership & related parties

Subparts reporting this organization as parent 6

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1299456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516924800000",
    "number": "1811295454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12868",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337332868",
            "telephone_number": "727-532-0002",
            "fax_number": "727-266-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 10TH STREET N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051407",
            "telephone_number": "727-532-1355",
            "fax_number": "727-266-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SC PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-07",
        "last_updated": "2018-01-26",
        "status": "A",
        "authorized_official_last_name": "GORKEN",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "VP, PFS",
        "authorized_official_telephone_number": "727-532-1355",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003689300",
            "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 26, 2018; 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.