Edward K Kankam, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS7965 Issued in FL

Practice address

293 NW Peacock Blvd Ste 101-104
Port Saint Lucie, FL 34986-2222

Phone

(772) 335-9600

Fax

(772) 879-4478

NPI assigned

Dec 5, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: ekankam34669@evernorth.direct-ci.com

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1114085842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "293 NW PEACOCK BLVD STE 101-104",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349862222",
            "telephone_number": "772-335-9600",
            "fax_number": "772-879-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "293 NW PEACOCK BLVD STE 101-104",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349862222",
            "telephone_number": "772-335-9600",
            "fax_number": "772-879-4478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1447 Medical Park Blvd.",
            "address_2": "SUITE 405",
            "address_purpose": "LOCATION",
            "city": "Wellington",
            "state": "FL",
            "postal_code": "334149325",
            "country_code": "US",
            "telephone_number": "561-792-7484",
            "fax_number": "561-792-7454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANKAM",
        "first_name": "EDWARD",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS7965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "260022600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• K and L Loving Care of Port Saint Lucie Assisted Living Facility, Inc
• K and L Loving Care of Port Saint Lucie II Assisted Living Facility in
• Tina Kadlecik
• Regina Elizabeth Kalinowski
• John Kalogris
• Alexander Katz, M.D.
• Kayla Gittens LLC
• Savanna Keen
• Keep in Touch Therapeutic Massage & Assessment, Inc.
• Vincent Kelleher, H.A.S.

• Family Medicine Physician in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.