Dunnellon Podiatry Center P a

Primary specialty

PodiatristTaxonomy code 213E00000X

License

P02759 Issued in FL

Legal business name

DUNNELLON PODIATRY CENTER P A

Practice address

11786 Cedar Street
Dunnellon Podiatry Center PA
Dunnellon, FL 34431

Phone

(352) 489-6621

Fax

(352) 489-6920

NPI assigned

Jul 16, 2006

Last updated

Dec 12, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stacy Lynn Witfill, DPMNPI 1285815647

Title

Owner Podiatrist

Phone

(352) 489-6621

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Locations

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.

• Stacy Lynn Witfill, DPM

  • Podiatrist
  • Dunnellon, FL
  • NPI 1285815647
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197417600000",
    "number": "1194742148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2633",
            "address_2": "DUNNELLON PODIATRY CENTER PA",
            "city": "DUNNELLON",
            "state": "FL",
            "postal_code": "34430",
            "telephone_number": "352-489-6621",
            "fax_number": "352-489-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11786 CEDAR STREET",
            "address_2": "DUNNELLON PODIATRY CENTER PA",
            "city": "DUNNELLON",
            "state": "FL",
            "postal_code": "34431",
            "telephone_number": "352-489-6621",
            "fax_number": "352-489-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNNELLON PODIATRY CENTER P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2007-12-12",
        "status": "A",
        "authorized_official_last_name": "WITFILL",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER PODIATRIST",
        "authorized_official_telephone_number": "352-489-6621",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "P02759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "65619",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathleen Blake Dunn, OT
• Dunnellon Adult Day Care, LLC
• Dunnellon Center for Complete Dentistry PA (Dunnellon Center for Complete Dentistry)
• Dunnellon Dentistry
• Dunnellon Eye Care LLC
• Dunnellon Taxi and Car Service LLC
• Ronnie Lee Durrance, LMT
• Lisa Dutkiewicz, LMT
• Stephanie Edworthy
• Kaitlyn Marie Eichler, APRN

• Podiatrist in Dunnellon, FL
• Providers in Dunnellon, FL by specialty
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.