Organization Active NPI

Podiatry Associates of the Palm Beaches LLC

  • Podiatrist
  • West Palm Beach, FL
National Provider Identifier
1063607950
Registry record updated Nov 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
PODIATRY ASSOCIATES OF THE PALM BEACHES LLC
Practice address
8190 Okeechobee Blvd
Suite 101
West Palm Beach, FL 33411-2047
Phone
(561) 358-6054
Fax
(561) 848-1940
NPI assigned
Sep 13, 2007
Last updated
Nov 5, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2007

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

Authorized official

Name
Dr. Kali Melissa Etheredge, DPM
Title
Member Manager
Phone
(786) 271-7688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

8190 Okeechobee Blvd
Suite 101
West Palm Beach, FL 33411-2047

Mailing address

1616 39TH St
West Palm Beach, FL 33407-3634
Phone (786) 271-7688

National Provider Directory

National Provider Directory

Locations

8190 Okeechobee Blvd
Ste 103
West Palm Beach, FL 33411
Phone (561) 358-6054

NPI Registry JSON

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1063607950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 39TH ST",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334073634",
            "telephone_number": "786-271-7688",
            "fax_number": "561-848-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8190 OKEECHOBEE BLVD",
            "address_2": "SUITE 101",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334112047",
            "telephone_number": "561-358-6054",
            "fax_number": "561-848-1940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY ASSOCIATES OF THE PALM BEACHES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "ETHEREDGE",
        "authorized_official_first_name": "KALI",
        "authorized_official_middle_name": "MELISSA",
        "authorized_official_title_or_position": "MEMBER MANAGER",
        "authorized_official_telephone_number": "786-271-7688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.