RONNIE E SUGGS DPM PA (CENTRAL FLORIDA FOOT CLINIC PC) - NPI NUMBER 1154467736

Summary

Provider Name: RONNIE E SUGGS DPM PA (CENTRAL FLORIDA FOOT CLINIC PC)

NPI Number: 1154467736

Clasification: Podiatrist (213E00000X)

Address:
6922 SEMINOLE DR
ORLANDO, FL
ZIP 32812

Phone Number: (407) 240-0002



Detailed Information

RONNIE E SUGGS DPM PA is a podiatrist in Orlando, FL. 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. The assigned NPI number for this provider is 1154467736 and is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Central Florida Foot Clinic Pc.

The provider's business address is:

6922 SEMINOLE DR
ORLANDO, FL
ZIP 32812-713
Phone: (407) 240-0002
Fax: (407) 240-0088

The provider's authorized official is Ronnie Eugene Suggs .
The authorized official title is Podiatrist and has the following contact phone number (407) 240-0002.

The enumeration date for this NPI number is 1/30/2007 and was last updated on 6/13/2008.

Map - Location of Practice

Taxonomy Codes

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 213E00000X Podiatrist PO2451 FL Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 390230700 MEDICAID FL
2 40317 MEDICARE ID-TYPE UNSPECIFIED FL
3 T61117 MEDICARE UPIN
4 480021182 OTHER RAILROAD MEDICARE

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1154467736 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name RONNIE E SUGGS DPM PA The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider Other Organization Name CENTRAL FLORIDA FOOT CLINIC PC Other name by which the organization provider is or has been known.
6 Provider Other Organization Name Type Code 5 Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/ a) name; 4 = former legal business name; 5 = other.
7 Provider First Line Business Practice Location Address 6922 SEMINOLE DR The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Business Practice Location Address City Name ORLANDO The city name in the location address of the provider being identified.
9 Provider Business Practice Location Address State Name FL The State code in the location of the provider being identified.
10 Provider Business Practice Location Address Postal Code 328123713 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
11 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
12 Provider Business Practice Location Address Telephone Number 4072400002 The telephone number associated with the location address of the provider being identified.
13 Provider Business Practice Location Address Fax Number 4072400088 The fax number associated with the location address of the provider being identified.
14 Provider Enumeration Date 1/30/2007 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 6/13/2008 The date that a record was last updated or changed.
16 Authorized Official Last Name SUGGS The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
17 Authorized Official First Name RONNIE The first name of the authorized official.
18 Authorized Official Middle Name EUGENE The middle name of the authorized official.
19 Authorized Official Title or Position PODIATRIST The title or position of the authorized official.
20 Authorized Official Telephone Number 4072400002 The 10-position telephone number of the authorized official.
21 Healthcare Provider Taxonomy Code 1 213E00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
22 Provider License Number 1 PO2451 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
23 Provider License Number State Code 1 FL The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
24 Healthcare Provider Primary Taxonomy Switch 1 Y
25 Other Provider Identifier 1 390230700 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
26 Other Provider Identifier Type Code 1 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
27 Other Provider Identifier State 1 FL
28 Other Provider Identifier 2 40317 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
29 Other Provider Identifier Type Code 2 04 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
30 Other Provider Identifier State 2 FL
31 Other Provider Identifier 3 T61117 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
32 Other Provider Identifier Type Code 3 02 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
33 Other Provider Identifier 4 480021182 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
34 Other Provider Identifier Type Code 4 01 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
35 Other Provider Identifier Issuer 4 RAILROAD MEDICARE
36 Is Organization Subpart N
37 Authorized Official Name Prefix Text DR.
38 Authorized Official Credential Text DPM
39 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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