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TANNELLE MCDOUGLE PA
NPI 1407296197
Physician Assistant - Medical in St Petersburg, FL

Active since June 27, 2013PECOS Enrolled
4260 CENTRAL AVE, ST PETERSBURG, FL 33711(727) 339-5496(727) 361-6247 Get Directions Write a Review

NPPES record last updated: February 5, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Feb 5, 2026, Jun 16, 2023, Mar 15, 2023 (3 updates tracked since 2023).

About Tannelle Mcdougle Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TANNELLE MCDOUGLE PA (NPI 1407296197) is an individual medical provider in St Petersburg, Florida, licensed in Florida (PA9107285) and active in the NPI registry since June 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407296197
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameTANNELLE MCDOUGLECredential: PA
Location Address4260 CENTRAL AVESt Petersburg, FL 33711-1140
Mailing Address4260 Central AveSt Petersburg, FL 33711-1140 · (727) 339-5496 · Fax (727) 361-6247
Phone(727) 339-5496
Fax(727) 361-6247
Sole ProprietorYes
Enumeration DateJune 27, 2013
Last NPPES UpdateFebruary 5, 20263 updates tracked since enumeration
NPPES CertifiedFebruary 5, 2026
✔ NPI 1407296197 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in FL · PA9107285
4260 CENTRAL AVE, St Petersburg, FL 33711
Open in Google Maps ↗

Other Names 1

Former Name (1)Tannelle Clarke

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tannelle Mcdougle Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERIC MCDOUGLE P.A.
Physician Assistant (Medical)
4260 CENTRAL AVE
ST PETERSBURG, FL 33711
Pinellas County (727) 339-5496

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tannelle Mcdougle's NPI number?

The NPI number for Tannelle Mcdougle is 1407296197. It was assigned to this individual provider in the NPPES registry on June 27, 2013. The provider is also known as Tannelle Clarke.

Where is Tannelle Mcdougle located?

Tannelle Mcdougle practices at 4260 Central Ave, St Petersburg, FL 33711. The listed phone number is (727) 339-5496.

What is Tannelle Mcdougle's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Tannelle Mcdougle enrolled in Medicare?

Yes. Tannelle Mcdougle is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tannelle Mcdougle was last updated on February 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.