Kali Etheredge, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

PO3255 Issued in FL

Practice address

701 Park Ave
Lake Park, FL 33403-2503

Phone

(561) 848-7722

Fax

(561) 848-7812

NPI assigned

Aug 2, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

Barry University School of Podiatric Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palm Beach Foot and Ankle IncGroup PAC ID 1456379056, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary's Medical Center Hospital, West Palm Beach, FL, CCN 100288

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Palm Beach Foot & Ankle Inc

  • Foot & Ankle Surgery Podiatrist
  • Palm Beach Gardens, FL
  • NPI 1316035454
  Medicare reassignment Care Compare group NPD
• Palm Beach Foot & Ankle Inc

  • Foot & Ankle Surgery Podiatrist
  • Boca Raton, FL
  • NPI 1508219353
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Mary's Medical Center, Inc

  dba St. Mary's Medical Center

  • General Acute Care Hospital
  • West Palm Beach, FL
  • NPI 1952333205
  Care Compare affiliation

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1063429702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11380 PROSPERITY FARMS RD STE 221E",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334103465",
            "telephone_number": "561-848-7722",
            "fax_number": "561-848-7812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PARK AVE",
            "city": "LAKE PARK",
            "state": "FL",
            "postal_code": "334032503",
            "telephone_number": "561-848-7722",
            "fax_number": "561-848-7812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHEREDGE",
        "first_name": "KALI",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2023-03-07",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD001044",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO3255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PO3255",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "POD001044",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Empathic Psychiatry, LLC
• Evichie (tropical garden north)
• Jose Luis Fanjul Rivero
• Fenix Recovery, LLC
• Helen Ferreira, APRN
• Floirda Oasis Bayberry LLC (Florida Oasis)

• Podiatrist in Lake Park, FL
• Providers in Lake Park, FL by specialty
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.