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PATRICK MANOR
NPI 1578992392
Assisted Living Facility in St Petersburg, FL

Active since November 02, 2013CLIA 10D2201474 · Waiver
896 73RD AVE N, ST PETERSBURG, FL 33702(727) 521-1843(727) 521-1100 Get Directions Write a Review

NPPES record last updated: November 2, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Patrick Manor NPPES

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

PATRICK MANOR (NPI 1578992392) is a healthcare organization registered as an assisted living facility in St Petersburg, Florida and active in the NPI registry since November 2013. The organization holds a CLIA Waiver certificate valid through November 19, 2026 and lists Theresa Putnam, Owner, as its authorized official.

NPPES Registry Identity

NPI1578992392
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NamePATRICK MANOR
Location Address896 73RD AVE NSt Petersburg, FL 33702-5220
Mailing Address896 73rd Ave NSt Petersburg, FL 33702-5220 · (727) 521-1843 · Fax (727) 521-1100
Phone(727) 521-1843
Fax(727) 521-1100
Organization SubpartNo
Authorized OfficialTheresa PutnamOwner · (727) 521-1843
Enumeration DateNovember 2, 2013
✔ NPI 1578992392 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in FL · AL10248
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
896 73RD AVE N, St Petersburg, FL 33702
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D2201474

Patrick Manor Incorporated · Saint Petersburg, FL
Active · expires Nov 19, 2026
CLIA Number10D2201474
Laboratory TypeAssisted Living Facility
Certificate Effective DateNovember 20, 2024
Certificate Expiration DateNovember 19, 2026
Laboratory DirectorTheresa L. Putnam
Laboratory Phone(727) 521-1843
Laboratory LocationPatrick Manor Incorporated896 73rd Ave N, Saint Petersburg, FL 33702
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Patrick Manor's NPI number?

The NPI number for Patrick Manor is 1578992392. It was assigned to this organization in the NPPES registry on November 2, 2013.

Where is Patrick Manor located?

Patrick Manor is located at 896 73rd Ave N, St Petersburg, FL 33702. The listed phone number is (727) 521-1843.

What is Patrick Manor's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Patrick Manor hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D2201474) is associated with this NPI, valid through November 19, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Patrick Manor was last updated on November 2, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years 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.