NPIMap

Organization Active NPI

Timothy C. Runyon, D.P.M. P.a.

Doing business as Certified Foot and Ankle Specialists

  • Non-Pharmacy Dispensing Site
  • Fort Myers, FL
National Provider Identifier
1679177661
Registry record updated Oct 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
TIMOTHY C. RUNYON, D.P.M. P.A.
Doing business as
Certified Foot and Ankle Specialists
Practice address
12681 New Brittany Blvd # 1E
Fort Myers, FL 33907-3631
Phone
(239) 689-3843
Fax
(239) 689-3852
NPI assigned
Nov 30, 2020
Last updated
Oct 9, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
TIMOTHY C. RUNYON, D.P.M. P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 9, 2024

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

Authorized official

Name
Kyle J Kinmon, DPMNPI 1023076312
Title
President
Phone
(561) 995-0229

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

12681 New Brittany Blvd # 1E
Fort Myers, FL 33907-3631

Mailing address

12681 New Brittany Blvd # 1E
Fort Myers, FL 33907-3631
Phone (239) 689-3843

Other names 1

  • Certified Foot and Ankle Specialists Doing business as

National Provider Directory

National Provider Directory
Part of
Timothy C Runyon DPM PA

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1606694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1679177661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12681 NEW BRITTANY BLVD # 1E",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073631",
            "telephone_number": "239-689-3843",
            "fax_number": "239-689-3852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12681 NEW BRITTANY BLVD # 1E",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073631",
            "telephone_number": "239-689-3843",
            "fax_number": "239-689-3852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY C. RUNYON, D.P.M. P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TIMOTHY C. RUNYON, D.P.M. P.A.",
        "enumeration_date": "2020-11-30",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "KINMON",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "561-995-0229",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Certified Foot and Ankle Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Certified Foot and Ankle Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2024; 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.