NPIMap

Organization Active NPI

Pamela Kirby PA

Doing business as Dr Pamel Kirby DPM

  • Podiatric Clinic/Center
  • Port Orange, FL
National Provider Identifier
1679892996
Registry record updated May 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
License
PO0002581 Issued in FL
Legal business name
PAMELA KIRBY PA
Doing business as
Dr Pamel Kirby DPM
Practice address
4606 South Clyde Morris Boulevard
Suite 1J
Port Orange, FL 32129
Phone
(386) 788-4111
Fax
(386) 788-4113
NPI assigned
May 26, 2010
Last updated
May 26, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2010

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

Authorized official

Name
Pamela Kibry, DOM
Title
President
Phone
(386) 788-4111

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X NU
Medical Specialty Clinic/Center 261QM2500X AP2222 FL
Podiatric Clinic/Center 261QP1100X PO3308 FL
Podiatric Clinic/Center 261QP1100X PO2796 FL
Podiatric Clinic/Center 261QP1100X PO0002581 FL Primary
Physical Therapy Clinic/Center 261QP2000X PT17909 FL

Addresses

Primary practice location

4606 South Clyde Morris Boulevard
Suite 1J
Port Orange, FL 32129

Mailing address

4606 South Clyde Morris Boulevard
Suite 1J
Port Orange, FL 32129
Phone (386) 788-4111

Other names 1

  • DR PAMEL KIRBY DPM Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dr Pamel Kirby DPM2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1274832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274832000000",
    "number": "1679892996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4606 SOUTH CLYDE MORRIS BOULEVARD",
            "address_2": "SUITE 1J",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "32129",
            "telephone_number": "386-788-4111",
            "fax_number": "386-788-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4606 SOUTH CLYDE MORRIS BOULEVARD",
            "address_2": "SUITE 1J",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "32129",
            "telephone_number": "386-788-4111",
            "fax_number": "386-788-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAMELA KIRBY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-26",
        "last_updated": "2010-05-26",
        "status": "A",
        "authorized_official_last_name": "KIBRY",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-788-4111",
        "authorized_official_credential": "DOM"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "FL",
            "license": "AP2222",
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "FL",
            "license": "PO3308",
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "FL",
            "license": "PO2796",
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "FL",
            "license": "PO0002581",
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "FL",
            "license": "PT17909",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DR PAMEL KIRBY DPM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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.