TC Physicians LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

TC PHYSICIANS LLC

Practice address

1100 SW Saint Lucie West Blvd Ste 209
Port St Lucie, FL 34986-1735

Phone

(772) 204-8889

Fax

(772) 204-8895

NPI assigned

Apr 16, 2020

Organization subpart

No

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

Authorized official

Name

Siddhartha Pagidipati

Title

Owner

Phone

(772) 204-8889

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1586995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587340800000",
    "number": "1831718154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MARINER BLVD",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346095603",
            "telephone_number": "352-277-5305",
            "fax_number": "352-616-0926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SW SAINT LUCIE WEST BLVD STE 209",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349861735",
            "telephone_number": "772-204-8889",
            "fax_number": "772-204-8895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TC PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-16",
        "last_updated": "2020-04-20",
        "certification_date": "2020-04-20",
        "status": "A",
        "authorized_official_last_name": "PAGIDIPATI",
        "authorized_official_first_name": "SIDDHARTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-204-8889"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Port St Lucie, FL
• Providers in Port St Lucie, 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 20, 2020; 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.