Individual provider Active NPI

Kristin K Rizzo, DPM

  • Foot & Ankle Surgery Podiatrist
  • Orlando, FL
National Provider Identifier
1558522029
Registry record updated Oct 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD1105 Issued in GA
Practice address
5201 Raymond St
Orlando, FL 32803-8208
Phone
(321) 397-6965
NPI assigned
Jun 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X POD1105 GA Primary

Addresses

Primary practice location

5201 Raymond St
Orlando, FL 32803-8208

Mailing address

5302 Harris Cir
Dunwoody, GA 30338-3709
Phone (407) 865-4668

Other names 1

  • Kristin D Kelley Former name

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120814000279 FL Order and Referring Only - PodiatryPractitioner - Podiatry 9830345487

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD1105GAMDFoot & Ankle Surgery Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1558522029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5302 HARRIS CIR",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303383709",
            "telephone_number": "407-865-4668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5201 RAYMOND ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328038208",
            "telephone_number": "321-397-6965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZZO",
        "first_name": "KRISTIN",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD1105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "KELLEY",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.