Individual provider Active NPI

Patricia Diane Korducavich, A.P.

  • Acupuncturist
  • St Petersburg, FL
National Provider Identifier
1972791952
Registry record updated Jun 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AP1390 Issued in FL
Practice address
5000 10TH St N
St Petersburg, FL 33703-2704
Phone
(813) 891-6139
NPI assigned
Oct 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AP1390 FL Primary

Addresses

Primary practice location

5000 10TH St N
St Petersburg, FL 33703-2704

Mailing address

12433 Seabrook Dr
Ste E
Tampa, FL 33626-2432
Phone (813) 891-6139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AP1390FLMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403568000000",
    "number": "1972791952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12433 SEABROOK DR",
            "address_2": "STE E",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336262432",
            "telephone_number": "813-891-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 10TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337032704",
            "telephone_number": "813-891-6139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORDUCAVICH",
        "first_name": "PATRICIA",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "A.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-04",
        "last_updated": "2014-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "FL",
            "license": "AP1390",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 24, 2014; 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.