ST. JUDE RADIOLOGY MEDICAL GROUP, INC. (NPI# 1659893626) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659893626 |
| Entity Type | Organization |
| Organization Name | ST. JUDE RADIOLOGY MEDICAL GROUP, INC. |
| Practice Address |
7214 Wareham Dr Tampa FL 33647-1166 |
| Mailing Address |
Po Box 940 Newbury Park CA 91319-0940 |
| Practice Telephone | 7149923978 |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2017-07-12 |
| Authorized Official Name | BRADLEY A. JACKSON (MEDICAL DIRECTOR / CEO) |
| Authorized Official Telephone | 7149923978 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790208155 | St. Jude Radiology Medical Group, Inc. | Radiology | 8070 Entrada De Luz E, San Diego, CA 92127-2561 | 2017-07-18 |
| 1043732001 | St. Jude Radiology Medical Group, Inc. | Radiology | 2059 Stratford Ave, South Pasadena, CA 91030-4640 | 2017-07-12 |
| 1750803722 | St. Jude Radiology Medical Group, Inc. | Radiology | 215 Tiburon Ct, Walnut Creek, CA 94597-3437 | 2017-07-12 |
| 1043732019 | St. Jude Radiology Medical Group, Inc. | Radiology | 4608 T St, Sacramento, CA 95819-4744 | 2017-07-12 |
| 1609398676 | St. Jude Radiology Medical Group, Inc. | Radiology | 6043 E Birdcage Ct, Orange, CA 92869-6015 | 2017-07-12 |
| Street Address |
7214 WAREHAM DR |
| City | TAMPA |
| State | FL |
| Zip Code | 33647-1166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851398143 | Robert Hawkins Vanfleet | Radiology | 7214 Wareham Dr, Tampa, FL 33647-1166 | 2005-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558972935 | Innovative Healthcare of Florida, Inc. | Home Health | 8903 Bruce B Downs Blvd, Tampa, FL 33647 | 2020-08-11 |
| 1093331498 | Envision In-home Companion Svcs | Home Health | 8903 Bruce B. Downs Blvd, Suite #140, Tampa, FL 33647 | 2020-06-22 |
| 1538788344 | Deanna Rene Shelpman | Massage Therapist | 15443 Plantation Oaks Dr, Apt 13, Tampa, FL 33647 | 2020-04-11 |
| 1316598998 | Paramount Health Group LLC | In Home Supportive Care | 17425 Bridge Hill Crt. Unit 200b, Tampa, FL 33647 | 2019-09-24 |
| 1174185656 | S&k Management Services | Clinical Nurse Specialist | 19046 Bruce B. Downs Blvd, Ste 177, Tampa, FL 33647 | 2019-07-03 |
| 1760040133 | Calisia Sapp | Clinic/Center | 19046 Bruce B Downs Blvd Ste B6-703, Tampa, FL 33647 | 2019-05-31 |
| 1306400106 | B2b Apps Solutions, LLC | Durable Medical Equipment & Medical Supplies | 17931 Cachet Isle Drive, Tampa, FL 33647 | 2019-04-26 |
| 1376000919 | Florida Homecare Specialists Minority Corp | Home Health | 5331 Primrose Lake Circle Unit 116, Tampa, FL 33647 | 2019-03-01 |
| 1982188157 | Dynamic Support Solutions, LLC | Home Health | 8606 Baneberry Ct, Tampa, FL 33647 | 2018-09-24 |
| 1982197430 | Erika Mendoza-hutto | Nurse Practitioner | 20713 Center Oak Dr, Tampa, FL 33647 | 2018-06-10 |
| Find all providers in zip 33647 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144834763 | Tower Imaging LLC | Radiology | 17416 Brookside Trace Ct., Tampa, FL 33647-3589 | 2020-09-01 |
| 1366067712 | Baycare Outpatient Imaging LLC | Radiology | 711 S Dale Mabry Hwy, Tampa, FL 33609-4445 | 2020-06-11 |
| 1306482088 | Michael P. Flynn | Radiology | 1003 Bay Harbour Place, Tampa, FL 33602 | 2019-11-18 |
| 1528526977 | Raddoctor, Pa | Radiology | 9203 Pine Island Ct, Tampa, FL 33647-2301 | 2019-03-05 |
| 1588023261 | Florida Gulfcoast Medical Imaging LLC | Radiology | 9822 Tree Tops Lake Rd, Tampa, FL 33626-4764 | 2016-02-23 |
| 1063803302 | Ahmed Sherif | Radiology | 2 Tampa General Cir # 7035, Usf Dept of Radiology, South Tampa Center, Tampa, FL 33606-3603 | 2015-02-09 |
| 1780015297 | St. Joseph's Diagnostic Center, LLC. | Radiology | 2222 W Swann Ave, Tampa, FL 33606-2426 | 2013-12-09 |
| 1245576651 | Radiology Associates of Tampa Pa | Radiology | 5 Tampa General Cir Ste 800, Harborside Medical Clinic, Tampa, FL 33606-3601 | 2012-12-13 |
| 1427282151 | Eric Matthew Lenz | Radiology | 3004 W San Miguel St, Tampa, FL 33629-6043 | 2009-05-09 |
| 1699929380 | Charles Howard Fisher | Radiology | 4904 Andros Dr, Tampa, FL 33629-4802 | 2008-11-09 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.