DR. KALI ETHEREDGE DPM NPI 1063429702

NPI Information

  • NPI: 1063429702
  • Provider Name: DR. KALI ETHEREDGE, DPM
  • Classification: Podiatrist - 213E00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 701 PARK AVE
    LAKE PARK, FL
    ZIP 33403
  • Phone: (561) 848-7722

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NPI Details

DR. Kali Etheredge, DPM is a podiatrist in Lake Park, FL with 22 years of experience. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. DR. Kali Etheredge, DPM NPI is 1063429702. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: BARRY UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Graduation Year:2004

The provider's business location address is:

701 PARK AVE
LAKE PARK, FL
ZIP 33403-503
Phone: (561) 848-7722
Fax: (561) 848-7812

The NPI 1063429702 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Follow-up nursing facility visit per day, typically 15 minutes (HCPCS:99308)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Removal of skin and tissue, 20.0 sq cm or less (HCPCS:11042)
  • Removal of fingernails or toenails, 6 or more nails (HCPCS:11721)
  • Follow-up nursing facility visit per day, typically 10 minutes (HCPCS:99307)
  • Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)
  • Removal of noncancer thickened skin growth, 2-4 growths (HCPCS:11056)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • X-ray of foot, minimum of 3 views (HCPCS:73630)

The enumeration date for this NPI number is 8/2/2006 and was last updated on 3/7/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatristPOD001044GEORGIANo
2213E00000XPodiatristPO3255FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1PO3255OTHERFLORIDASTATE LICENSE
2POD001044OTHERGEORGIASTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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