Active NPI
Kozhimala Thomas John, MD
- Internal Medicine Physician
- Zephyrhills, FL
National Provider Identifier
1891890638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- ME23148
- Practice address
- 6336 Fort King Rd
Zephyrhills, FL 33542 - Phone
- (727) 322-1054
- Fax
- (727) 821-7213
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | ME23148 | FL | |
| Internal Medicine Physician | 207R00000X | ME23148 | FL | Primary |
Addresses
Primary practice location
6336 Fort King Rd
Zephyrhills, FL 33542
Mailing address
1839 Central Ave
St Petersburg, FL 33713-8900
Phone (727) 322-1054
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 058391000 | Medicaid | FL | |
| 51086 | Other | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME23148 | FL | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Health Care of Pinellas LLC | Internal Medicine | Current | Accepting new patients |
| Professional Health Care of Pinellas Inc. | Current | Accepting new patients | |
| Elizabeth a John MD PA | Internal Medicine | Past | Accepting new patients |
Locations
1839 Central Ave
St Petersburg, FL 33713
Phone (727) 322-1054
6336 Fort King Rd
Zephyrhills, FL 33542
Phone (813) 640-0060
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EIJHAA
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- St Petersburg, FL
- NPI 1881647253
-
- Chiropractor
- St Petersburg, FL
- NPI 1568970903
-
- Internal Medicine Physician
- Zephyrhills, FL
- NPI 1164513271
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620604800000",
"number": "1891890638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1839 CENTRAL AVE",
"city": "ST PETERSBURG",
"state": "FL",
"postal_code": "337138900",
"telephone_number": "727-322-1054",
"fax_number": "727-821-7213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6336 FORT KING RD",
"city": "ZEPHYRHILLS",
"state": "FL",
"postal_code": "33542",
"telephone_number": "727-322-1054",
"fax_number": "727-821-7213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHN",
"first_name": "KOZHIMALA",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2021-05-10",
"certification_date": "2021-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "FL",
"license": "ME23148",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "FL",
"license": "ME23148",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "058391000",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "51086",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Zephyrhills, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; 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.