First Coast Foot & Ankle Clinic Inc

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

PO3091 Issued in FL

Legal business name

FIRST COAST FOOT & ANKLE CLINIC INC

Practice address

8075 Gate Pkwy W
Suite 301
Jacksonville, FL 32216-3684

Phone

(904) 739-9129

Fax

(904) 739-9127

NPI assigned

May 8, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Vimal Reddy, DPMNPI 1962470617

Title

Owner Physician

Phone

(904) 739-9129

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Vimal A Reddy, DPM

  • Foot & Ankle Surgery Podiatrist
  • Jacksonville, FL
  • NPI 1962470617

  O20100930032435

  Same enrollment

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/ECJADA

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Vimal A Reddy, DPM

  • Foot & Ankle Surgery Podiatrist
  • Jacksonville, FL
  • NPI 1962470617
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428624000000",
    "number": "1013120963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8075 GATE PKWY W",
            "address_2": "SUITE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163684",
            "telephone_number": "904-739-9129",
            "fax_number": "904-739-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8075 GATE PKWY W",
            "address_2": "SUITE 301",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163684",
            "telephone_number": "904-739-9129",
            "fax_number": "904-739-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST COAST FOOT & ANKLE CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2015-04-10",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "VIMAL",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "904-739-9129",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO3091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME PIN",
            "identifier": "6330940002",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• First Coast Dermatology P a
• First Coast Diabetes Institute, LLC
• First Coast Eye Associates, PA
• First Coast Eyewear Inc
• First Coast Family Medicine PA
• First Coast FS, LLC
• First Coast Health Ventures, LLC
• First Coast Heart & Vascular Center, PA
• First Coast Hospitalist P L
• First Coast Imaging LLC

• Foot Surgery Podiatrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Foot Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.