Individual provider Active NPI

Fanta Vaughn Morgan-Kitson, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Dover, DE
National Provider Identifier
1376756080
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E1-0000188 Issued in DE
Practice address
22 Old Rudnick LN
Dover, DE 19901-4912
Phone
(302) 674-9255
Fax
(302) 674-9096
NPI assigned
May 8, 2007
Last updated
Feb 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X SC005937 PA
Foot & Ankle Surgery Podiatrist 213ES0103X E1-0000188 DE Primary

Addresses

Primary practice location

22 Old Rudnick LN
Dover, DE 19901-4912

Mailing address

22 Old Rudnick LN
Dover, DE 19901-4912
Phone (302) 674-9255

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE, MD, DC3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20090722000292 DE Practitioner - Podiatry 1456403401 Reassigns benefits to 3 organizations
I20200218000029 MD Practitioner - Podiatry 1456403401 Reassigns benefits to 1 organization
I20220412000986 DC Practitioner - Podiatry 1456403401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pedirite Medical MD LLCGroup PAC ID 7810312717, 5 clinicians
Pedirite Medical de LLCGroup PAC ID 3779970942, 2 clinicians

Practice addresses (Care Compare)

2015 E W Hwy
Silver Spring, MD 20910-2602
Phone 201870119471

2801 W 6TH St
Wilmington, DE 19805-1828
Phone (212) 764-0008

3330 Wilkens Ave
Baltimore, MD 21229-4610
Phone (201) 870-1194

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue2127
Removal or shaving of skin growth387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E1-0000188DEMDFoot & Ankle Surgery Podiatrist
SC005937PAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Sole Purpose Podiatry, LLC CurrentSince Apr 10, 2020 Accepting new patients
Pedirite Medical de LLC CurrentSince Feb 15, 2022 Accepting new patients
Pedirite Medical MD LLC CurrentSince Feb 15, 2022 Accepting new patients

Locations

2801 W 6th St
Wilmington, DE 19805
Phone (302) 655-6135

3330 Wilkens Ave
Baltimore, MD 21229
Phone (410) 525-1544

2015 E West Hwy
Silver Spring, MD 20910
Phone (202) 932-8149

267 Broadway
Fl 2
Brooklyn, NY 11211
Phone (716) 912-5877

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, 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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1376756080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 OLD RUDNICK LN",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199014912",
            "telephone_number": "302-674-9255",
            "fax_number": "302-674-9096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 OLD RUDNICK LN",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199014912",
            "telephone_number": "302-674-9255",
            "fax_number": "302-674-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORGAN-KITSON",
        "first_name": "FANTA",
        "middle_name": "VAUGHN",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC005937",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "DE",
            "license": "E1-0000188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.