Individual provider Active NPI

Kathleen Marie Starbird, M. D.

  • Geriatric Medicine (Internal Medicine) Physician
  • Tavares, FL
National Provider Identifier
1568515997
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
ME 81405 Issued in FL
Practice address
12300 Lane Park Rd
Tavares, FL 32778-9660
Phone
(352) 343-1341
Fax
(352) 343-6115
NPI assigned
Jan 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X ME 81405 FL Primary

Addresses

Primary practice location

12300 Lane Park Rd
Tavares, FL 32778-9660

Mailing address

12300 Lane Park Rd
Tavares, FL 32778-9660
Phone (352) 343-1341

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
I20140916000689 FL Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 9830318336 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Health Services LLC CurrentSince Jul 19, 2014 Accepting new patients
Cornerstone Health Services LLC CurrentSince Jul 19, 2014 Accepting new patients

Locations

1414 Kuhl Ave
Orlando, FL 32806
Phone (407) 464-9516

2445 Lane Park Rd
Tavares, FL 32778
Phone (866) 280-9355

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1568515997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12300 LANE PARK RD",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327789660",
            "telephone_number": "352-343-1341",
            "fax_number": "352-343-6115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12300 LANE PARK RD",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327789660",
            "telephone_number": "352-343-1341",
            "fax_number": "352-343-6115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARBIRD",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "M. D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "FL",
            "license": "ME 81405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tavares, FL

Sources for this page

Verify at the official NPI Registry.