Individual provider Active NPI

David E. Nunnelly, M. D.

  • Diagnostic Radiology Physician
  • Clearwater, FL
National Provider Identifier
1992795074
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
ME56316 Issued in FL
Practice address
1106 Druid Rd S
Suite 302
Clearwater, FL 33756-3846
Phone
(727) 441-3711
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X ME56316 FL Primary

Addresses

Primary practice location

1106 Druid Rd S
Suite 302
Clearwater, FL 33756-3846

Mailing address

PO Box 660
Clearwater, FL 33757-0660
Phone (727) 793-9300

Other identifiers 1

IdentifierTypeStateIssuer
08934OtherFLBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200615002943 CA Practitioner - Diagnostic Radiology 8022915529 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Kentucky College of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Managed Imaging Medical Group IncGroup PAC ID 9436229887, 76 clinicians

Practice addresses (Care Compare)

147 N Brent St
Ventura, CA 93003-2809
Phone (805) 652-5011

Hospital & facility affiliations

  • Community Memorial Hospital - Ventura Hospital, Ventura, CA, CCN 050394
  • St Johns Regional Medical Center Hospital, Oxnard, CA, CCN 050082
  • Community Memorial Hospital - Ojai Hospital, Ojai, CA, CCN 051334
  • Goleta Valley Cottage Hospital Hospital, Santa Barbara, CA, CCN 050357
  • Santa Ynez Valley Cottage Hospital Hospital, Solvang, CA, CCN 051331

Merit-based Incentive Payment System (MIPS)

Final score
91.25 of 100Reported as group
Quality
75
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
84.53 of 100Reported as individual
Quality
76.67
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Pronet Imaging Medical Group, Inc. Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
California Managed Imaging Medical Group, Inc Diagnostic Radiology CurrentSince May 9, 2020 Accepting new patients
San Fernando Valley Interventional Radiology and Imaging Center CurrentSince Jul 1, 2020 Accepting new patients
Beverly Radiology Medical Group III Diagnostic Radiology CurrentSince Jul 1, 2020 Accepting new patients
Medical Specialist Associates of Florida LLC Past Accepting new patients
Pueblo Radiology Medical Group Inc Diagnostic Radiology Past Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients
Clearwater Resources Inc Diagnostic Radiology Past Accepting new patients
Premier Radiology, LLP Diagnostic Radiology Past Accepting new patients
Radiology Associates of St. Petersburg PA Diagnostic Radiology PastSince Sep 8, 2019 Accepting new patients
Suncoast Medical Clinic LLC Past Accepting new patients
Advanced Imaging, LLP Diagnostic Radiology Past Accepting new patients
MRI-South Umberton Inc Diagnostic Radiology Past Accepting new patients

Locations (25 of 29)

18523 Corwin Rd
Ste J
Apple Valley, CA 92307
Phone (760) 242-4444

8750 Wilshire Blvd
Ste 100
Beverly Hills, CA 90211
Phone (310) 689-3100

2309 Antonio Ave
Camarillo, CA 93010
Phone (805) 389-5655

801 S Main St
Ste 101
Corona, CA 92882
Phone (951) 682-1099

16311 Ventura Blvd
Ste 120
Encino, CA 91436
Phone (818) 817-7707

16130 Ventura Blvd
Ste 100
Encino, CA 91436
Phone (818) 933-2020

6107 N Fresno St
Ste 101
Fresno, CA 93710
Phone (559) 435-4433

9191 Westminster Ave
Ste 105
Garden Grove, CA 92844
Phone (714) 583-6314

250 S 12th Ave
Hanford, CA 93230
Phone (559) 295-2450

2679 Zoe Ave
Huntington Park, CA 90255
Phone (323) 584-3333

3715 E South St
Long Beach, CA 90805
Phone (562) 602-0700

3320 N Los Coyotes Diagonal
Ste 120
Long Beach, CA 90808
Phone (562) 627-0903

1516 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2843

27168 Newport Rd
Ste B
Menifee, CA 92584
Phone (951) 566-5725

3909 Waring Rd
Ste Bc
Oceanside, CA 92056
Phone (760) 630-0014

1306 Maricopa Hwy
Ojai, CA 93023
Phone (805) 640-2260

1600 N Rose Ave
Oxnard, CA 93030
Phone (805) 988-2500

2001 Solar Dr
Ste 135
Oxnard, CA 93036
Phone (805) 861-2200

2151 E Gonzales Rd
Ste 101
Oxnard, CA 93036
Phone (805) 988-0616

Dept LA 21738
Pasadena, CA 91185

2320 Bath St
Ste 211
Santa Barbara, CA 93105
Phone (805) 560-8111

2320 Bath St
Ste 208
Santa Barbara, CA 93105

2320 Bath St
Ste 113
Santa Barbara, CA 93105
Phone (805) 560-8111

351 S Patterson Ave
Santa Barbara, CA 93111
Phone (805) 681-6406

2050 Viborg Rd
Solvang, CA 93463
Phone (805) 686-3961

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1992795074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 660",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337570660",
            "telephone_number": "727-793-9300",
            "fax_number": "727-793-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 DRUID RD S",
            "address_2": "SUITE 302",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337563846",
            "telephone_number": "727-441-3711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNNELLY",
        "first_name": "DAVID",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "ME56316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "08934",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.