John B. Decosmo,III, D.O., P.a.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

OS5534 Issued in FL

Legal business name

JOHN B. DECOSMO,III, D.O., P.A.

Practice address

4800 4TH St N
St Petersburg, FL 33703-3817

Phone

(727) 498-6488

Fax

(727) 362-6772

NPI assigned

Oct 17, 2011

Last updated

Apr 12, 2015By 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

Dr. John B Decosmo, DONPI 1396721221

Title

President

Phone

(727) 498-6488

Specialties & licenses 1

Addresses

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.

• John B Decosmo, DO

  • Family Medicine Physician
  • St Petersburg, FL
  • NPI 1396721221
  Authorized official Same address or phone

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

{
    "created_epoch": "1318809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428796800000",
    "number": "1831474303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337033817",
            "telephone_number": "727-498-6488",
            "fax_number": "727-362-6772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 4TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337033817",
            "telephone_number": "727-498-6488",
            "fax_number": "727-362-6772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN B. DECOSMO,III, D.O., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-17",
        "last_updated": "2015-04-12",
        "status": "A",
        "authorized_official_last_name": "DECOSMO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "727-498-6488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "FL",
            "license": "OS5534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlin Jockers
• Joel Marantz, OD,PA
• David L Joffe, R.PH. CDE, FACA, CPT
• Naomi G Johansen, MD
• Lori Ann Johanson-Grimes, O.T.
• John Drygas LLC (Infinity Neurosurgery)
• John E Davis, DDS, P.a.
• John E Kern DO PA
• John F Kirk MD, PA
• John H. Mason P a

• Primary Care Clinic/Center in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Primary Care Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2015; 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.