T Gail Stark, DPM

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

PO2420 Issued in FL

Practice address

11739 Chanticleer Dr
Pensacola, FL 32507-4150

Phone

(850) 982-2625

NPI assigned

Nov 3, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 10

Addresses

Other identifiers 1

Other names 1

• Dr. Teressa Gail Stark Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336608000000",
    "number": "1750460341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34150",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325074150",
            "telephone_number": "850-982-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11739 CHANTICLEER DR",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325074150",
            "telephone_number": "850-982-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "T",
        "middle_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-03",
        "last_updated": "2012-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO2420",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AL",
            "license": "160",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "FL",
            "license": "PO2420",
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "AL",
            "license": "160",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "FL",
            "license": "PO2420",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "AL",
            "license": "160",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "FL",
            "license": "PO2420",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "AL",
            "license": "160",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO2420",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "AL",
            "license": "160",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390273100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESSA",
            "last_name": "STARK",
            "middle_name": "GAIL",
            "prefix": "DR.",
            "credential": "DPM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sabrina Stanley
• Stephanie Bell Stanton, PHARMD
• Star Sports Medicine PA
• Stark Performance Physical Therapy
• Paul Hunter Stark, PT
• Monique E Starke, PT, DPT
• Sonya L Starnes
• William Joseph Starsiak Jr., DDS
• Starvision Optometry PLLC
• Billie Jo Staszewski, RBT

• Primary Podiatric Medicine Podiatrist in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Primary Podiatric Medicine Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; 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.