NPIMap

Organization Active NPI

Vidya P Kini MD PL

  • Specialist
  • Fort Myers, FL
National Provider Identifier
1336384643
Registry record updated Apr 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME56122 Issued in FL
Legal business name
VIDYA P KINI MD PL
Practice address
35 Barkley Cir
Suite 1
Fort Myers, FL 33907-7601
Phone
(239) 274-5464
NPI assigned
Dec 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2013

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

Authorized official

Name
Vidya P Kini, MD
Title
Owner
Phone
(239) 274-5464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X ME56122 FL Primary

Addresses

Primary practice location

35 Barkley Cir
Suite 1
Fort Myers, FL 33907-7601

Mailing address

35 Barkley Cir
Suite 1
Fort Myers, FL 33907-7601
Phone (239) 274-5464

Other identifiers 3

IdentifierTypeStateIssuer
036091100MedicaidFL
4122518OtherFLAETNA
3720007001OtherFLCIGNA

National Provider Directory

National Provider Directory

Locations

35 Barkley Cir
Ste 1
Fort Myers, FL 33907
Phone (239) 274-5464

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": "1229385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365724800000",
    "number": "1336384643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 BARKLEY CIR",
            "address_2": "SUITE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339077601",
            "telephone_number": "239-274-5464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 BARKLEY CIR",
            "address_2": "SUITE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339077601",
            "telephone_number": "239-274-5464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIDYA P KINI MD PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-16",
        "last_updated": "2013-04-12",
        "status": "A",
        "authorized_official_last_name": "KINI",
        "authorized_official_first_name": "VIDYA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-274-5464",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME56122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036091100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4122518",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3720007001",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.