Charles Andrew Krivenko, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME79832 Issued in FL

Practice address

1550 Wilton LN
Sanibel, FL 33957-4223

Phone

(239) 395-2949

NPI assigned

Feb 21, 2013

Last updated

Feb 21, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1361404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1558601997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 WILTON LN",
            "city": "SANIBEL",
            "state": "FL",
            "postal_code": "339574223",
            "telephone_number": "239-395-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 WILTON LN",
            "city": "SANIBEL",
            "state": "FL",
            "postal_code": "339574223",
            "telephone_number": "239-395-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRIVENKO",
        "first_name": "CHARLES",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-02-21",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME79832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyle Edward Hotchkiss, D.D.S.
• Island Pharmacy Inc
• Island Therapy Services of Sanibel, LLC (Island Therapy Center)
• Steven Alan Jerrett, M.D.
• Susan Ransom Klemmer, LMHC, NCC
• Edward P Lamotta, MD
• Millennium Physician Group LLC
• Northland Hearing Centers, Inc (Auditory Associates Hearing Center)
• Nuke Me, PA
• Donald L. Olsen, PT

• Family Medicine Physician in Sanibel, FL
• Providers in Sanibel, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.