Kelly a. Poncheri DPM PA

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO 3478 Issued in FL

Legal business name

KELLY A. PONCHERI DPM PA

Doing business as

Foot & Ankle Institute of Central Florida

Practice address

4692 Exploration Ave
Lakeland, FL 33812-4107

Phone

(239) 278-1155

NPI assigned

May 12, 2011

Organization subpart

No

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

Authorized official

Name

Kelly Poncheri, DPM

Title

Owner

Phone

(239) 278-1155

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Foot & Ankle Institute of Central Florida Doing business as

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

{
    "created_epoch": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309996800000",
    "number": "1619269362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4692 EXPLORATION AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338124107",
            "telephone_number": "239-278-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4692 EXPLORATION AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338124107",
            "telephone_number": "239-278-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY A. PONCHERI DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-07-07",
        "status": "A",
        "authorized_official_last_name": "PONCHERI",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-278-1155",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO 3478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "PO 3478",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foot & Ankle Institute of Central Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Keith Hilliard DMD PA
• D'Laynie Keith
• Louise Elizabeth Kelley, MS, RN, FNP-C
• Megan Nissen Kelley, PHARMD
• Scott T. Kelley, MD
• Alaina Kelly
• Joseph Lee Kelly, COUNSELOR
• Larissa Kelly, CCC-SLP
• Andrew Brandon Kelso, D.M.D.
• Shannon Holer Kelso, DMD

• Foot & Ankle Surgery Podiatrist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Foot & Ankle Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2011; 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.