Dr. Pamela Kirby PA

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

PO2581 Issued in FL

Legal business name

DR. PAMELA KIRBY PA

Practice address

4606 S Clyde Morris Blvd
1 J
Port Orange, FL 32129-7453

Phone

(386) 788-4111

Fax

(386) 788-4113

NPI assigned

May 19, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Pamela Kirby, DPM

Title

Owner

Phone

(386) 788-4111

Specialties & licenses 5

Addresses

Other names 1

• Pamela Kirby, DPM Doing business as

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1174780134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4606 S CLYDE MORRIS BLVD",
            "address_2": "1 J",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321297453",
            "telephone_number": "386-788-4111",
            "fax_number": "386-788-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 S CLYDE MORRIS BLVD",
            "address_2": "1 J",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321297453",
            "telephone_number": "386-788-4111",
            "fax_number": "386-788-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. PAMELA KIRBY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "KIRBY",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-788-4111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "FL",
            "license": "PO2796",
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "FL",
            "license": "PO2581",
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "FL",
            "license": "PO0003382",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PT17909",
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PT10210",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pamela Kirby, DPM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dr. Pamela Kirby PA
• Mallory Driggers, MA, LMHC
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• Emily Driscoll
• DRP Chiropractic LLC

• Podiatric Clinic/Center in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Podiatric Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.