MOBILE PODIATRIST PC NPI 1861692402

NPI Information

NPI: 1861692402
Provider Name: MOBILE PODIATRIST, PC
Classification: Podiatrist - 213EP1101X
Entity Type: Organization

Specialization: Primary Podiatric Medicine

Address:
1558 VICTORIA CT
GREENWOOD, IN
ZIP 46143
Phone: (317) 697-6536
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MOBILE PODIATRIST, PC is a primary podiatric medicine podiatrist in Greenwood, IN. MOBILE PODIATRIST, PC NPI is 1861692402. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1558 VICTORIA CT
GREENWOOD, IN
ZIP 46143-884
Phone: (317) 697-6536
Fax: (317) 859-2923

The provider's authorized official is Irene Erica Roge .
The authorized official title is President and has the following contact phone number (317) 697-6536.

The enumeration date for this NPI number is 7/23/2007 and was last updated on 6/3/2011.

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	213EP1101X	Podiatrist	Primary Podiatric Medicine	016-004848	ILLINOIS	No
2	213EP1101X	Podiatrist	Primary Podiatric Medicine	07001009A	INDIANA	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	DF0688	OTHER	INDIANA	RAILROAD MEDICARE
2	DE1825	OTHER	ILLINOIS	RAILROAD MEDICARE
3	6505710001	MEDICARE NSC	INDIANA
4	212873	MEDICARE PIN	ILLINOIS
5	233170	MEDICARE PIN	INDIANA

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: 5/5/2024

NPI Synchronization or Removal

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