NPIMap

Organization Active NPI

Timothy C. Runyon, DPM, PA

  • Non-Pharmacy Dispensing Site
  • Fort Myers, FL
National Provider Identifier
1023784188
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
TIMOTHY C. RUNYON, DPM, PA
Practice address
2540 Winkler Ave
Fort Myers, FL 33901-9338
Phone
(239) 278-4100
NPI assigned
Aug 19, 2021
Last updated
Oct 9, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Authorized official

Name
Kyle J KinmonNPI 1023076312
Title
Ceo
Phone
(561) 995-0229

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

2540 Winkler Ave
Fort Myers, FL 33901-9338

Mailing address

1401 16TH St N
St Petersburg, FL 33704-4123
Phone (727) 894-0794

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

12681 New Brittany Blvd
#1E
Fort Myers, FL 33907
Phone (239) 689-3843

2540 Winkler Ave
Fort Myers, FL 33901
Phone (239) 278-4100

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1023784188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 16TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337044123",
            "telephone_number": "727-894-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 WINKLER AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019338",
            "telephone_number": "239-278-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY C. RUNYON, DPM, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-19",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "KINMON",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "561-995-0229"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.