Individual provider Active NPI

Kendis Garrett, MD

  • Pediatrics Physician
  • Coral Springs, FL
National Provider Identifier
1326035155
Registry record updated Dec 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
ME49251 Issued in FL
Practice address
7451 Wiles Rd
Suite 205
Coral Springs, FL 33067-2040
Phone
(954) 345-6838
Fax
(954) 345-6848
NPI assigned
Oct 6, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 2008

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 ME49251 FL Primary

Addresses

Primary practice location

7451 Wiles Rd
Suite 205
Coral Springs, FL 33067-2040

Mailing address

7451 Wiles Rd
Suite 205
Coral Springs, FL 33067-2040
Phone (954) 345-6838

Other identifiers 1

IdentifierTypeStateIssuer
039161100MedicaidFL

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
I20041109000800 FL Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 6406819531 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Pediatrics of Broward LLC Pediatrics CurrentSince Jun 1, 2011 Accepting new patients
Phoenix Pediatrics of Broward LLC Pediatrics CurrentSince Jun 1, 2011 Accepting new patients
HHA Associates LLC CurrentSince Mar 1, 2022 Accepting new patients
Pompano ER Pediatrics LLC Past Accepting new patients

Locations

1600 S Andrews Ave
Ft Lauderdale, FL 33316
Phone (954) 355-4000

8201 W Broward Blvd
Plantation, FL 33324
Phone (954) 476-3900

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

7201 N University Dr
Tamarac, FL 33321
Phone (954) 721-2200

3114 Croasdaile Dr
#200
Durham, NC 27705
Phone (877) 751-1157

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229385600000",
    "number": "1326035155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7451 WILES RD",
            "address_2": "SUITE 205",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330672040",
            "telephone_number": "954-345-6838",
            "fax_number": "954-345-6848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7451 WILES RD",
            "address_2": "SUITE 205",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330672040",
            "telephone_number": "954-345-6838",
            "fax_number": "954-345-6848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARRETT",
        "first_name": "KENDIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2008-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME49251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "039161100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coral Springs, FL

Sources for this page

Verify at the official NPI Registry.