MS. MODUPE D MCINTOSH CPNP NPI 1174522916

NPI Information

  • NPI: 1174522916
  • Provider Name: MS. MODUPE D MCINTOSH, CPNP
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 13577 FEATHER SOUND DR
    CLEARWATER, FL
    ZIP 33762
  • Phone: (904) 902-4408

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NPI Details

MS. Modupe D Mcintosh, CPNP is a psychiatric/mental health nurse practitioner in Clearwater, FL. MS. Modupe D Mcintosh, CPNP NPI is 1174522916. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

13577 FEATHER SOUND DR
CLEARWATER, FL
ZIP 33762-258
Phone: (904) 902-4408
Fax: (904) 420-4745

The NPI 1174522916 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/14/2005 and was last updated on 3/20/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0200XNurse PractitionerPediatricsRN092844GEORGIANo
2363LP0808XNurse PractitionerPsychiatric/Mental HealthAPRN11031023FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1554500072AMEDICAIDGEORGIA
2554500072DMEDICAIDGEORGIA
3554500072EMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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