FOOTPRINT PODIATRY CONSULTANTS LLC NPI 1083932438

NPI Information

NPI: 1083932438
Provider Name: FOOTPRINT PODIATRY CONSULTANTS, LLC

Former Legal Business Name: FOOTPRINT PODIATRY CONSULTANTS, LLC

Classification: Clinic/Center - 261QP1100X
Entity Type: Organization

Specialization: Podiatric

Address:
1328 SOUTHERN AVE SE
SUITE 209
WASHINGTON, DC
ZIP 20032
Phone: (202) 506-1001
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FOOTPRINT PODIATRY CONSULTANTS, LLC is a podiatric clinic center in Washington, DC. FOOTPRINT PODIATRY CONSULTANTS, LLC NPI is 1083932438. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Footprint Podiatry Consultants, Llc.

The provider's business location address is:

1328 SOUTHERN AVE SE
SUITE 209
WASHINGTON, DC
ZIP 20032-689
Phone: (202) 506-1001
Fax: (202) 506-1008

The provider's authorized official is Michangelo Darren Scruggs .
The authorized official title is Podiatrist/ceo and has the following contact phone number (202) 506-1001.

The enumeration date for this NPI number is 5/10/2010 and was last updated on 8/2/2010.

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
1	261QP1100X	Clinic/Center	Podiatric	PO1000031	DISTRICT OF COLUMBIA	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	050785700	MEDICAID	DISTRICT OF COLUMBIA
2	491626	MEDICARE PIN	DISTRICT OF COLUMBIA
3	306106	OTHER	DISTRICT OF COLUMBIA	UNISON
4	0000289842002	OTHER	DISTRICT OF COLUMBIA	UNITED HEALTHCARE
5	U96803	MEDICARE UPIN
6	31290	OTHER	DISTRICT OF COLUMBIA	DC CHARTERED HEALTH
7	J892	OTHER	DISTRICT OF COLUMBIA	CAREFIRST BC/BS
8	947AMD-MD	OTHER	DISTRICT OF COLUMBIA	CAREFIRST BC/BS

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: 4/28/2024

NPI Synchronization or Removal

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