Family Podiatry P C

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

01129 Issued in MD

Legal business name

FAMILY PODIATRY P C

Practice address

5632 Annapolis Rd Ste 12
Bladensburg, MD 20710-2213

Phone

(301) 390-4440

Fax

(202) 726-0656

NPI assigned

Sep 16, 2008

Last updated

Nov 16, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Teresa L Hilliard, DPMNPI 1558445379

Title

Owner

Phone

(301) 390-4440

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD, DC3 enrollments

Enrollment records 3

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4379/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Teresa Leah Hilliard, DPM

  • Podiatrist
  • Bladensburg, MD
  • NPI 1558445379

  DC

  Medicare reassignment NPD Authorized official
• Ogechukwu Imonugo, DPM

  • Podiatrist
  • Columbia, MD
  • NPI 1619330172

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1221523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1023267903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 QUACKENBOS ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200111229",
            "telephone_number": "301-390-4440",
            "fax_number": "202-726-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5632 ANNAPOLIS RD STE 12",
            "city": "BLADENSBURG",
            "state": "MD",
            "postal_code": "207102213",
            "telephone_number": "301-390-4440",
            "fax_number": "202-726-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PODIATRY P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-16",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "HILLIARD",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-390-4440",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "VA",
            "license": "103000906",
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "DC",
            "license": "PO517",
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "MD",
            "license": "01129",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011297300",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel A Emiola
• Okechukwu N Emmanuel
• Josephine Ayuk Enow
• Emuke Epoge
• Constance Ezeudu
• Linda Fan
• Florence Idowu Fashina
• Oluwafunmbi Fasina
• Arleen L Faulkner, LCPC
• Claire M Fenelus

• Podiatric Clinic/Center in Bladensburg, MD
• Providers in Bladensburg, MD by specialty
• Podiatric Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.