NPIMap

Individual provider Active NPI

Timothy C Runyon, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • St Petersburg, FL
National Provider Identifier
1881657740
Registry record updated Feb 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO1101 Issued in FL
Practice address
1401 16TH St N
St Petersburg, FL 33704-4123
Phone
(727) 894-0794
Fax
(727) 895-1215
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2016

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X FP1101 FL
Sports Medicine Podiatrist 213ES0000X PO1101 FL
Primary Podiatric Medicine Podiatrist 213EP1101X PO1101 FL
Radiology Podiatrist 213ER0200X PO1101 FL
Foot & Ankle Surgery Podiatrist 213ES0103X PO1101 FL Primary

Addresses

Primary practice location

1401 16TH St N
St Petersburg, FL 33704-4123

Mailing address

1401 16TH St N
St Petersburg, FL 33704-4123
Phone (727) 894-0794

Other identifiers 2

IdentifierTypeStateIssuer
0854680001OtherFLDMERC
041079900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
FP1101FLMDDurable Medical Equipment & Medical Supplies

Practice roles

OrganizationSpecialtyStatusNew patients
Timothy C. Runyon, DPM, PA Primary Podiatric Medicine Past Accepting new patients
Timothy C. Runyon, DPM, PA Foot & Ankle Surgery Past Accepting new patients
Timothy C. Runyon, DPM, PA Foot & Ankle Surgery Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1881657740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 16TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337044123",
            "telephone_number": "727-894-0794",
            "fax_number": "727-895-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 16TH ST N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337044123",
            "telephone_number": "727-894-0794",
            "fax_number": "727-895-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNYON",
        "first_name": "TIMOTHY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "FL",
            "license": "FP1101",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "FL",
            "license": "PO1101",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "FL",
            "license": "PO1101",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Radiology",
            "state": "FL",
            "license": "PO1101",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO1101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0854680001",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041079900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.