PAMELA KIRBY PA (NPI# 1679892996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679892996 |
| Entity Type | Organization |
| Organization Name | PAMELA KIRBY PA |
| Other Organization Name | DR PAMEL KIRBY DPM |
| Practice Address |
4606 South Clyde Morris Boulevard Suite 1j Port Orange FL 32129 |
| Practice Telephone | 3867884111 |
| Practice Fax Number | 3867884113 |
| Mailing Telephone | 3867884111 |
| Mailing Fax Number | 3867884113 |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2010-05-26 |
| Authorized Official Name | PAMELA KIBRY (PRESIDENT) |
| Authorized Official Telephone | 3867884111 |
| Authorized Official Credential | DOM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities | ||
| N | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
AP2222 | FL | Ambulatory Health Care Facilities |
| N | 261QP1100X |
Clinic/Center Specialization: Podiatric |
PO3308 | FL | Ambulatory Health Care Facilities |
| N | 261QP1100X |
Clinic/Center Specialization: Podiatric |
PO2796 | FL | Ambulatory Health Care Facilities |
| N | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
PT17909 | FL | Ambulatory Health Care Facilities |
| Y | 261QP1100X |
Clinic/Center Specialization: Podiatric |
PO0002581 | FL | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| DR PAMEL KIRBY DPM | Doing Business As Name - Organization |
| Street Address |
4606 SOUTH CLYDE MORRIS BOULEVARD SUITE 1J |
| City | PORT ORANGE |
| State | FL |
| Zip Code | 32129 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982179818 | Port Orange Modern Dentistry, Pa | Dentist | 1765 Dunlawton Ave., Suite 103, Port Orange, FL 32129 | 2018-10-08 |
| 1932698131 | Brittany Michele Claude | Behavioral Analyst | 4647 Clyde Morris Blvd Suite 501, Port Orange, FL 32129 | 2018-05-03 |
| 1760919468 | Makayla Earl | Behavior Technician | 1557 Town Park Dr., Port Orange, FL 32129 | 2017-05-12 |
| 1184157968 | Katie Lynn Weisz | Physician Assistant | 3635 South Clyde Morris Blvd, Suite 100, Port Orage, FL 32129 | 2017-04-07 |
| 1285178319 | Mallory Driggers | Counselor | 980 Canal View Blvd Apt F7, Port Orange, FL 32129 | 2016-12-08 |
| 1912321654 | Edward L. Staudt Dds & Kenneth L. Staudt Dds, Mph | Dentist | 944 Bridgewater Dr., Suite 2-b, Port Orange, FL 32129 | 2014-02-18 |
| 1538411731 | Roberta Ann Gilmartin | Specialist | 1048 W Samms Ave, Port Orange, FL 32129 | 2012-10-11 |
| 1326376385 | Connie Jeanne Bodnarik | Physical Therapy Assistant | 3780 S Clyde Morris Blvd Apt 1206, Port Orange, FL 32129 | 2009-12-02 |
| 1669645057 | American Family & Sports Chiropractic Center Inc | Chiropractor | 4649 Clyde Morris Blvd Unit 609, Port Orange, FL 32129 | 2008-04-08 |
| 1831212182 | Lydia Marin Calimarea Dmd,pa | Dentist | 1525 Herbert Street,suit 101, Poret Orange, FL 32129 | 2007-04-09 |
| Find all providers in zip 32129 | ||||
| Taxonomy Code | 261QP1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Podiatric |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174780134 | Dr. Pamela Kirby Pa | Clinic/Center | 4606 S Clyde Morris Blvd, 1 J, Port Orange, FL 32129-7453 | 2008-05-19 |
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| 1922535830 | Jemaar Graham Dpm Pa | Clinic/Center | 12839 Grand Bank Ln, Orlando, FL 32825-2737 | 2017-05-23 |
| 1306398839 | Modern Podiatry, Pa | Clinic/Center | 1151 Miranda Ln, Kissimmee, FL 34741-0763 | 2016-11-01 |
| 1346625522 | J&e Jackson Enterprises, Pllc | Clinic/Center | 1677 Eagle Harbor Pkwy # C, Fleming Island, FL 32003-4802 | 2015-07-29 |
| 1598023624 | Giselle Ojeda Dpm Pa | Clinic/Center | 6039 Collins Ave, 311, Miami Beach, FL 33140-2203 | 2012-04-26 |
| 1720363724 | J.m. Rehabilitation Center Corp | Clinic/Center | 10300 Sw 72nd St Ste 157, Miami, FL 33173-3038 | 2011-10-21 |
| 1598941411 | Steven James Pangborn Dpm Pa | Clinic/Center | 4879 Coconut Creek Pkwy, Coconut Creek, FL 33063-3944 | 2008-01-10 |
| Find all providers with the same taxonomy | ||||
| City | PORT ORANGE |
| Zip Code | 32129 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.