Individual provider Active NPI

Christopher Keith Kitterman, D.O.

  • Pediatrics Physician
  • St Petersburg, FL
National Provider Identifier
1235566852
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OS13886 Issued in FL
Practice address
1344 22ND St S
St Petersburg, FL 33712-2744
Phone
(727) 824-8181
Fax
(727) 823-7427
NPI assigned
Sep 27, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OS13886 FL Primary

Addresses

Primary practice location

1344 22ND St S
St Petersburg, FL 33712-2744

Mailing address

14100 58TH St N
Clearwater, FL 33760-9900
Phone (727) 824-8181

Other identifiers 1

IdentifierTypeStateIssuer
017989600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170605000816 FL Practitioner - Pediatric Medicine 9537436084 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Centers of Pinellas Inc. CurrentSince Mar 12, 2017 Accepting new patients
Community Health Center of Pinellas Inc CurrentSince Mar 12, 2017 Accepting new patients
Community Health Center of Pinellas Inc Past Accepting new patients
Community Health Centers of Pinellas Inc. Pediatrics Past Accepting new patients

Locations

14100 58th St N
Ste 100
Clearwater, FL 33760
Phone (727) 286-6224

14100 58th St N
Clearwater, FL 33760

1260 S Mlk Jr Ave
Clearwater, FL 33756
Phone (727) 824-2121

707 Druid Rd E
Clearwater, FL 33756
Phone (727) 441-8963

12420 130th Ave N
Largo, FL 33774
Phone (727) 587-7729

7550 43rd St N
Pinellas Park, FL 33781
Phone (727) 290-4222

612 Dr Martin Luther King Jr St N
St Petersburg, FL 33705

4950 34th St N
St Petersburg, FL 33714

1344 22nd St S
St Petersburg, FL 33712
Phone (727) 821-6701

247 S Huey Ave
Tarpon Springs, FL 34689
Phone (727) 944-3828

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1380240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1235566852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14100 58TH ST N",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337609900",
            "telephone_number": "727-824-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1344 22ND ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337122744",
            "telephone_number": "727-824-8181",
            "fax_number": "727-823-7427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITTERMAN",
        "first_name": "CHRISTOPHER",
        "middle_name": "KEITH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-27",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "OS13886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "017989600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.