Active NPI
Certified Foot & Ankle Specialists
- Non-Pharmacy Dispensing Site
- Palm City, FL
National Provider Identifier
1104358357
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Non-Pharmacy Dispensing Site
- Legal business name
- CERTIFIED FOOT & ANKLE SPECIALISTS
- Practice address
- 2664 SW Immanuel Dr
Palm City, FL 34990-2738 - Phone
- (772) 288-3338
- Fax
- (772) 288-3341
- NPI assigned
- Mar 28, 2017
- Last updated
- Oct 9, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kyle Kinmon, MD
- Title
- Owner
- Phone
- (561) 425-2929
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | PO3007 | FL | |
| Non-Pharmacy Dispensing Site | 332900000X | Primary |
Addresses
Primary practice location
2664 SW Immanuel Dr
Palm City, FL 34990-2738
Mailing address
1601 Clint Moore Rd
Suite 130
Boca Raton, FL 33487-2768
Phone (561) 995-0229
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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.
-
- Foot & Ankle Surgery Podiatrist
- Boca Raton, FL
- NPI 1023076312
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490659200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1728432000000",
"number": "1104358357",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1601 CLINT MOORE RD",
"address_2": "SUITE 130",
"city": "BOCA RATON",
"state": "FL",
"postal_code": "334872768",
"telephone_number": "561-995-0229",
"fax_number": "561-989-0775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2664 SW IMMANUEL DR",
"city": "PALM CITY",
"state": "FL",
"postal_code": "349902738",
"telephone_number": "772-288-3338",
"fax_number": "772-288-3341"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CERTIFIED FOOT & ANKLE SPECIALISTS",
"organizational_subpart": "NO",
"enumeration_date": "2017-03-28",
"last_updated": "2024-10-09",
"certification_date": "2024-10-09",
"status": "A",
"authorized_official_last_name": "KINMON",
"authorized_official_first_name": "KYLE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "561-425-2929",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "FL",
"license": "PO3007",
"primary": false
},
{
"code": "332900000X",
"taxonomy_group": "",
"desc": "Non-Pharmacy Dispensing Site",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Palm City, 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.