Organization Active NPI

Kristi L Conway DPM PA

Doing business as Bay Area Podiatry Center

  • Podiatrist
  • Brandon, FL
National Provider Identifier
1265663777
Registry record updated May 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
KRISTI L CONWAY DPM PA
Doing business as
Bay Area Podiatry Center
Practice address
1149 Professional Park Dr
Brandon, FL 33511-4887
Phone
(813) 685-3668
Fax
(813) 685-5430
NPI assigned
Jul 31, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2016

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

Authorized official

Name
Dr. Kristi L Conway, DPMNPI 1114964558
Title
President
Phone
(813) 685-3668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

1149 Professional Park Dr
Brandon, FL 33511-4887

Mailing address

1149 Professional Park Dr
Brandon, FL 33511-4887
Phone (813) 685-3668

Other names 1

  • Bay Area Podiatry Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090915000686 FL Part B Supplier - Clinic/Group Practice 5799831855 Receives reassigned benefits from 2 practitioners
Practice locations: Brandon, FL
O20100930031465 FL DME Supplier - Physician - Podiatry 5799831855 Practice locations: Brandon, FL

National Provider Directory

National Provider Directory

Locations

1149 Professional Park Dr
Brandon, FL 33511
Phone (813) 685-3668

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462406400000",
    "number": "1265663777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1149 PROFESSIONAL PARK DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114887",
            "telephone_number": "813-685-3668",
            "fax_number": "813-685-5430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 PROFESSIONAL PARK DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114887",
            "telephone_number": "813-685-3668",
            "fax_number": "813-685-5430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTI L CONWAY DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-31",
        "last_updated": "2016-05-05",
        "status": "A",
        "authorized_official_last_name": "CONWAY",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "813-685-3668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Area Podiatry Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2016; 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.