Active NPI
Kimberley Jo Politte, COF
- Orthotic Fitter
- Loma Linda, CA
National Provider Identifier
1114053006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthotic Fitter
- License
- COFM-050
- Practice address
- 11201 Benton St
Loma Linda, CA 92357-1000 - Phone
- (909) 825-7084
- Fax
- (909) 777-3887
- NPI assigned
- Feb 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotic Fitter | 225000000X | COFM-050 | CA | Primary |
Addresses
Primary practice location
11201 Benton St
Loma Linda, CA 92357-1000
Mailing address
11201 Benton St
Loma Linda, CA 92357-1000
Phone (909) 825-7084
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| COFM-050 | CA | MD | Orthotic Fitter |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172448000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114053006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11201 BENTON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923571000",
"telephone_number": "909-825-7084",
"fax_number": "909-777-3887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11201 BENTON ST",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923571000",
"telephone_number": "909-825-7084",
"fax_number": "909-777-3887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POLITTE",
"first_name": "KIMBERLEY",
"middle_name": "JO",
"name_prefix": "Mrs.",
"credential": "COF",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225000000X",
"taxonomy_group": "",
"desc": "Orthotic Fitter",
"state": "CA",
"license": "COFM-050",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loma Linda, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.