Peace River Ankle & Foot, PL

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO3264 Issued in FL

Legal business name

PEACE RIVER ANKLE & FOOT, PL

Practice address

3440 Conway Blvd
1D
Port Charlotte, FL 33952-7000

Phone

(941) 624-3668

NPI assigned

Jul 1, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Holly K Waddell, DPM

Title

Owner/Podiatrist

Phone

(941) 624-3668

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1277942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299110400000",
    "number": "1023329331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 CONWAY BLVD",
            "address_2": "1D",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339527000",
            "telephone_number": "941-624-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 CONWAY BLVD",
            "address_2": "1D",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339527000",
            "telephone_number": "941-624-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE RIVER ANKLE & FOOT, PL",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-01",
        "last_updated": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "WADDELL",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/PODIATRIST",
        "authorized_official_telephone_number": "941-624-3668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Paul
• Julie Rose Pauly, ARNP
• Hannah Elizabeth Payne, LMHC, NCC
• PCP - Health PLLC
• Peace of Mind Internal Medicine PLLC Jennifer a Cooke Sole MBR
• Peace River Cardiovascular Center
• Peace River Hma Nursing Center Inc
• Peace River Physical Therapy & Rehabilitation, LLC
• Peace River Surgery Center
• Peachland Chiropractic Health LLC

• Foot & Ankle Surgery Podiatrist in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Foot & Ankle Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.