DR. KRISTIE LYNN TADDIE D.P.M. NPI 1861416547

NPI Information

NPI: 1861416547
Provider Name: DR. KRISTIE LYNN TADDIE, D.P.M.
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

Organization: KG HEALTH PARTNERS INC

PECOS Registration: Yes

Address:
13600 ICOT BLVD BLDG A
CLEARWATER, FL
ZIP 33760
Phone: (727) 796-6900
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DR. Kristie Lynn Taddie, D.P.M. is a foot and ankle surgery podiatrist in Clearwater, FL with 21 years of experience. DR. Kristie Lynn Taddie, D.P.M. NPI is 1861416547. 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:2003

The provider's business location address is:

13600 ICOT BLVD BLDG A
CLEARWATER, FL
ZIP 33760-703
Phone: (727) 796-6900
Fax: (727) 669-8417

The NPI 1861416547 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 enumeration date for this NPI number is 7/27/2006 and was last updated on 10/4/2021.

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
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	5901002145	MICHIGAN	No
2	213ES0103X	Podiatrist	Foot & Ankle Surgery	PO3265	FLORIDA	Yes

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
1	PO3265	OTHER	FLORIDA	PODIATRIC LICENSE
2	340608300	MEDICAID	FLORIDA
3	5901002145	OTHER	MICHIGAN	PODIATRIC MEDICINE AND SURGERY

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: 11/14/2023

NPI Synchronization or Removal

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