Active NPI
Coast to Coast Podiatry Inc
- Podiatrist
- Tarpon Springs, FL
National Provider Identifier
1790896264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- PO2713
- Legal business name
- COAST TO COAST PODIATRY INC
- Practice address
- 905 E Martin Luther King Jr Dr Ste 320
Tarpon Springs, FL 34689-4853 - Phone
- (727) 572-5449
- Fax
- (727) 573-2049
- NPI assigned
- Aug 31, 2006
- Last updated
- Mar 21, 2021
- Organization subpart
- Yes
- Parent organization
- COAST TO COAST PODIATRY INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Michael E Domis, DPM
- Title
- President
- Phone
- (727) 572-5449
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | PO2713 | FL | Primary |
Addresses
Primary practice location
905 E Martin Luther King Jr Dr Ste 320
Tarpon Springs, FL 34689-4853
Mailing address
PO Box 56
Palm Harbor, FL 34682-0056
Phone (727) 572-5449
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
National Provider Directory
National Provider Directory- Part of
- Coast to Coast Podiatry Inc
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Podiatrist
- Tampa, FL
- NPI 1124077474
-
- Podiatrist
- Trinity, FL
- NPI 1649282112
-
- Primary Podiatric Medicine Podiatrist
- St Petersburg, FL
- NPI 1245238948
-
- Podiatrist
- Delray Beach, FL
- NPI 1346287372
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1616284800000",
"number": "1790896264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 56",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346820056",
"telephone_number": "727-572-5449",
"fax_number": "278-445-4257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 E MARTIN LUTHER KING JR DR STE 320",
"city": "TARPON SPRINGS",
"state": "FL",
"postal_code": "346894853",
"telephone_number": "727-572-5449",
"fax_number": "727-573-2049"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "COAST TO COAST PODIATRY INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "COAST TO COAST PODIATRY INC",
"enumeration_date": "2006-08-31",
"last_updated": "2021-03-21",
"certification_date": "2021-03-21",
"status": "A",
"authorized_official_last_name": "DOMIS",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "727-572-5449",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "FL",
"license": "PO2713",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tarpon Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.