Individual provider Active NPI

Kristina Wynn Calicchio, DVM

  • Veterinarian
  • South Miami, FL
National Provider Identifier
1003117425
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
VM11042 Issued in FL
Practice address
6394 S Dixie Hwy
South Miami, FL 33143-4952
Phone
(305) 666-4142
Fax
(305) 661-2434
NPI assigned
Nov 16, 2010
Last updated
Nov 16, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X VM11042 FL Primary
Veterinarian 174M00000X 15228 CA

Addresses

Primary practice location

6394 S Dixie Hwy
South Miami, FL 33143-4952

Mailing address

6394 S Dixie Hwy
South Miami, FL 33143-4952
Phone (305) 666-4142

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
15228CAMDAddiction (Substance Use Disorder) Counselor
VM11042FLMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1003117425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6394 S DIXIE HWY",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434952",
            "telephone_number": "305-666-4142",
            "fax_number": "305-661-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6394 S DIXIE HWY",
            "city": "SOUTH MIAMI",
            "state": "FL",
            "postal_code": "331434952",
            "telephone_number": "305-666-4142",
            "fax_number": "305-661-2434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALICCHIO",
        "first_name": "KRISTINA",
        "middle_name": "WYNN",
        "name_prefix": "Dr.",
        "credential": "DVM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "FL",
            "license": "VM11042",
            "primary": true
        },
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "CA",
            "license": "15228",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.