EXCELSIOR PODIATRY CLINIC PLLC NPI 1003085515

NPI Information

  • NPI: 1003085515
  • Provider Name: EXCELSIOR PODIATRY CLINIC PLLC
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Organization
  • Address: 214 LAKEVIEW RD
    SOMERVILLE, TN
    ZIP 38068
  • Phone: (901) 516-4005

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NPI Details

EXCELSIOR PODIATRY CLINIC PLLC is a foot and ankle surgery podiatrist in Somerville, TN. EXCELSIOR PODIATRY CLINIC PLLC NPI is 1003085515. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

214 LAKEVIEW RD
SOMERVILLE, TN
ZIP 38068-737
Phone: (901) 516-4005
Fax: (901) 516-4023

The provider's authorized official is John Bell .
The authorized official title is Doctor and has the following contact phone number (901) 516-4005.

The enumeration date for this NPI number is 2/28/2008 and was last updated on 4/13/2010.

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
1213ES0103XPodiatristFoot & Ankle SurgeryDPM0000000649TENNESSEEYes

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
133542122MEDICARE PINTENNESSEE
233542121MEDICAIDTENNESSEE
36337480001MEDICARE NSCTENNESSEE

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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