Certified Foot & Ankle Specialists

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

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

Organization subpart

No

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

Specialties & licenses 2

Addresses

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": []
}

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• Non-Pharmacy Dispensing Site in Palm City, FL
• Providers in Palm City, FL by specialty
• Non-Pharmacy Dispensing Site in Florida

• 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.