Individual provider Active NPI

Brooke Kiefer Malloy, DPM

  • Podiatrist
  • Pensacola, FL
National Provider Identifier
1710681499
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO4779 Issued in FL
Practice address
1851 N 9TH Ave
Pensacola, FL 32503-4500
Phone
(850) 434-9867
NPI assigned
Mar 28, 2023
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO4779 FL Primary

Addresses

Primary practice location

1851 N 9TH Ave
Pensacola, FL 32503-4500

Mailing address

1851 N 9TH Ave
Pensacola, FL 32503-4500
Phone (850) 434-9867

Other practice location 1

Medical Center Boulevard
Winston Salem, NC 27157-7801
Phone (336) 716-8170

Other names 1

  • Brooke Elizabeth Kiefer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231002003547 NC Order and Referring Only - Orthopedic SurgeryPractitioner - Orthopedic Surgery 7618321175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Podiatry of Northwest Florida PA Podiatrist PastSince Dec 12, 1999 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1710681499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1851 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325034500",
            "telephone_number": "850-434-9867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 N 9TH AVE",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325034500",
            "telephone_number": "850-434-9867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Medical Center Boulevard",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271577801",
            "country_code": "US",
            "telephone_number": "336-716-8170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALLOY",
        "first_name": "BROOKE",
        "middle_name": "KIEFER",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO4779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BROOKE",
            "last_name": "KIEFER",
            "middle_name": "ELIZABETH",
            "credential": "DPM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.