SUPERIOR PODIATRY LLC NPI 1457839839

NPI Information

  • NPI: 1457839839
  • Provider Name: SUPERIOR PODIATRY, LLC
  • Classification: Podiatrist - 213ES0103X
  • Specialization: Foot & Ankle Surgery
  • Entity Type: Organization
  • Former Legal Business Name: ST JOHNS FOOT AND ANKLE SPECIALISTS, LLC
  • Address: 1690 US HIGHWAY 1 S STE C
    SAINT AUGUSTINE, FL
    ZIP 32084
  • Phone: (904) 436-8001

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NPI Details

SUPERIOR PODIATRY, LLC is a foot and ankle surgery podiatrist in Saint Augustine, FL. SUPERIOR PODIATRY, LLC NPI is 1457839839. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is St Johns Foot And Ankle Specialists, Llc.

The provider's business location address is:

1690 US HIGHWAY 1 S STE C
SAINT AUGUSTINE, FL
ZIP 32084-024
Phone: (904) 436-8001
Fax: (904) 377-6776

The provider's authorized official is John Randall Northrup .
The authorized official title is President/owner and has the following contact phone number (904) 436-8001.

The enumeration date for this NPI number is 7/30/2018 and was last updated on 11/5/2020.

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
1213E00000XPodiatristNo
2213ES0103XPodiatristFoot & Ankle SurgeryYes

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
1101522100MEDICAIDFLORIDA

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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