Kelly A Poncheri, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

SC006075 Issued in PA

Practice address

4712 Exploration Ave
Lakeland, FL 33812-3319

Phone

(863) 644-1313

NPI assigned

Sep 15, 2008

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

Practice roles

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.

• Chukwuka C Okafor, MD, Mba, PA

  • Orthopaedic Surgery of the Spine Physician
  • Lakeland, FL
  • NPI 1962714071
  NPD (past)

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

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1689823742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 S FLORIDA AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338132501",
            "telephone_number": "863-644-1313",
            "fax_number": "239-278-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4712 EXPLORATION AVE",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338123319",
            "telephone_number": "863-644-1313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONCHERI",
        "first_name": "KELLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-15",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC006075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dianne Polsen- Haas, MD
• Elizabeth Ann Polston, PHD, ARNP, WHNP-BC
• Laurie Pomella, APRN
• Ana Lesinay Pompa Gomez, RBT
• Karely Sarahi Ponce
• Marsha W Pope, LMHC
• Charity Eleanor Popp, PA-C
• Farbenzie Tcheska Porter
• Kecia Porter
• Mary Marie Porter, CCC-SLP

• 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 22, 2016; 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.