Individual provider Active NPI

Michael Brien Bloodworth Jr.

  • Certified Registered Nurse Anesthetist
  • Saint Petersburg, FL
National Provider Identifier
1992460117
Registry record updated Feb 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN11036844 Issued in FL
Practice address
701 6TH St S
Saint Petersburg, FL 33701-4891
Phone
(321) 841-2335
NPI assigned
Nov 2, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN152813 LA
Certified Registered Nurse Anesthetist 367500000X APRN11036844 FL Primary

Addresses

Primary practice location

701 6TH St S
Saint Petersburg, FL 33701-4891

Mailing address

701 6TH St S
Saint Petersburg, FL 33701-4891
Phone (321) 841-2335

Other practice location 1

315 Hospital Dr
Madison, TN 37115-5030
Phone (615) 868-6503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250129002408 FL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183153513 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ams National LLCGroup PAC ID 3870813025, 310 clinicians
Orlando Health Medical Group IncGroup PAC ID 9537059084, 2,171 clinicians

Practice addresses (Care Compare)

6945 1St Ave S
St Petersburg, FL 33707-1222
Phone (727) 302-9200

701 6TH St S
St Petersburg, FL 33701-4814
Phone (727) 893-6182

Hospital & facility affiliations

  • Orlando Health Bayfront Hospital Hospital, Saint Petersburg, FL, CCN 100032

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN152813LAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health Medical Group Inc CurrentSince Jan 10, 2025 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Jan 10, 2025 Accepting new patients
Sunshine State Anesthesia Partners LLC CurrentSince Apr 28, 2025 Accepting new patients

Locations

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

201 14th St SW
Largo, FL 33770
Phone (727) 588-5222

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

701 6th St S
St Petersburg, FL 33701
Phone (727) 450-1144

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738540800000",
    "number": "1992460117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 6TH ST S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337014891",
            "telephone_number": "321-841-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 6TH ST S",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337014891",
            "telephone_number": "321-841-2335"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "TN",
            "postal_code": "371155030",
            "country_code": "US",
            "telephone_number": "615-868-6503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLOODWORTH",
        "first_name": "MICHAEL BRIEN",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-02",
        "last_updated": "2025-02-03",
        "certification_date": "2025-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN152813",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11036844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.