McIlwain Medical Group, PA

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

ME26737 Issued in FL

Legal business name

MCILWAIN MEDICAL GROUP, PA

Practice address

4700 N Habana Ave
Suite 201
Tampa, FL 33614-7160

Phone

(813) 879-5485

Fax

(813) 870-1781

NPI assigned

Jul 13, 2012

Organization subpart

No

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

Authorized official

Name

Harris McIlwain, MD

Title

President

Phone

(813) 971-5550

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.

• Kelly Elizabeth Keough, PA-C

  • Medical Physician Assistant
  • Tampa, FL
  • NPI 1255798005
  NPD

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342137600000",
    "number": "1942555180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13801 BRUCE B DOWNS BLVD",
            "address_2": "SUITE 406",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336133946",
            "telephone_number": "813-971-5550",
            "fax_number": "813-903-1070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 N HABANA AVE",
            "address_2": "SUITE 201",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336147160",
            "telephone_number": "813-879-5485",
            "fax_number": "813-870-1781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCILWAIN MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-13",
        "last_updated": "2012-07-13",
        "status": "A",
        "authorized_official_last_name": "MCILWAIN",
        "authorized_official_first_name": "HARRIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-971-5550",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "FL",
            "license": "ME26737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jann McHollan, LMHC
• Emily Anne McHugh, N/A
• Jennifer Susan McIlvaine, DPT
• McIlwain Dental Specialists
• McIlwain Medical Group, PA
• James E McIlwain Jr., DDS
• Leigh Ann McIlwain, DMD
• Megan McInerney, LMHC
• Deborah Annice McInnis, OTRL
• Colleen Rebekah Maier McIntosh, DO

• Rheumatology Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Rheumatology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2012; 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.