Kelvin Devane Gipson, D.P.M
Individual provider Active NPI Foot & Ankle Surgery Podiatrist · Bonifay, FL
NPI 1013022698 · NPPES record last updated Aug 31, 2010
Key facts
- NPI
- 1013022698
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Foot & Ankle Surgery Podiatrist 213ES0103X
- License
- 1341 (VI)
- Practice address
- 2600 Hospital Dr
Doctors Memorial Hospital/Doctor'S Specialty Clinc
Bonifay, FL 32425-4264 - Phone
- (850) 547-8117
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1341 | VI | MD | Foot & Ankle Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Caribbean Neurosciences Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 1341 | VI | Yes |
Addresses
Primary practice location
2600 Hospital Dr
Doctors Memorial Hospital/Doctor'S Specialty Clinc
Bonifay, FL 32425-4264
Mailing address
PO Box 123
Argyle, FL 32422-0123
Phone (407) 443-9784
Other providers in Bonifay, FL
- Beverly Fendley
- Kelsey Danae Fentress
- Benedict Inlayo Florentin
- Florida Department of Health
- Foot First Podiatry
- Visit Supanich Giri
- H & H Non Emergency Transportation Inc.
- Rashel L Haddix
- Happy Acres
- Oliver Martin Hasek Jr.
All providers in Bonifay, FL · Foot & Ankle Surgery Podiatrist in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.