Katelyn Alina Pembroke, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

21210 Issued in FL

Practice address

2812 SW Mapp Rd
Palm City, FL 34990-2722

Phone

(772) 283-8350

NPI assigned

Jun 22, 2015

Last updated

Jun 22, 2015By the provider in NPPES

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

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aesthetic Dentistry of Palm City

  • Dentist
  • Palm City, FL
  • NPI 1881801488
  NPD (past)

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

{
    "created_epoch": "1434931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434931200000",
    "number": "1699157065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 NW FLAGLER AVE APT 301",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349941158",
            "telephone_number": "772-215-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 SW MAPP RD",
            "city": "PALM CITY",
            "state": "FL",
            "postal_code": "349902722",
            "telephone_number": "772-283-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEMBROKE",
        "first_name": "KATELYN",
        "middle_name": "ALINA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-22",
        "last_updated": "2015-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "21210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pediatric Specialty Group, Inc (Pediatric Specialists of America At Palm City)
• Pediatric Therapy Links, LLC
• Peerpals
• Jonathan Peirce
• Linda A Peirce, BCBA
• People Who Help People (Nautilus Senior home Care)
• Maria Isabel Perez, MS
• Sandra L Perkins, LCSW
• Mark L Perman, M.D.
• Annalisa Petrone-Clements

• General Practice Dentistry in Palm City, FL
• Providers in Palm City, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.