NPIMap

Organization Active NPI

Neshoba Foot and Ankle Clinic

  • Foot & Ankle Surgery Podiatrist
  • Philadelphia, MS
National Provider Identifier
1013142017
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
80193 Issued in MS
Legal business name
NESHOBA FOOT AND ANKLE CLINIC
Practice address
1003 Holland Ave
Suite 102
Philadelphia, MS 39350-2180
Phone
(601) 663-1423
Fax
(601) 663-1474
NPI assigned
May 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2009

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

Authorized official

Name
Mrs. Stephanie Butler
Title
Cbo Manager
Phone
(601) 663-1423

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 80193 MS Primary

Addresses

Primary practice location

1003 Holland Ave
Suite 102
Philadelphia, MS 39350-2180

Mailing address

1003 Holland Ave
Suite 102
Philadelphia, MS 39350-2180
Phone (601) 663-1423

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242691200000",
    "number": "1013142017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 HOLLAND AVE",
            "address_2": "SUITE 102",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502180",
            "telephone_number": "601-663-1423",
            "fax_number": "601-663-1474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 HOLLAND AVE",
            "address_2": "SUITE 102",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "393502180",
            "telephone_number": "601-663-1423",
            "fax_number": "601-663-1474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NESHOBA FOOT AND ANKLE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-19",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "CBO MANAGER",
        "authorized_official_telephone_number": "601-663-1423",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MS",
            "license": "80193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.