Charles Jeffrey Sidlow, D.P.M.

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

POD000560 Issued in GA

Practice address

958 Joe Frank Harris Pkwy SE BLDG a
Suite 106
Cartersville, GA 30120-2175

Phone

(770) 386-1389

Fax

(770) 386-4894

NPI assigned

Mar 23, 2006

Last updated

Dec 19, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Ga Podiatric Medicine and Surgery

  • Durable Medical Equipment & Medical Supplies
  • Cartersville, GA
  • NPI 1588842686
  Authorized official Same address or phone

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1033179270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "958 JOE FRANK HARRIS PKWY SE BLDG A",
            "address_2": "SUITE 106",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202175",
            "telephone_number": "770-386-1389",
            "fax_number": "770-386-4894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "958 JOE FRANK HARRIS PKWY SE BLDG A",
            "address_2": "SUITE 106",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301202175",
            "telephone_number": "770-386-1389",
            "fax_number": "770-386-4894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIDLOW",
        "first_name": "CHARLES",
        "middle_name": "JEFFREY",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "GA",
            "license": "POD000560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000333803A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne L Shimsky, LPC
• Erica Eunseo Shin, OD
• Hamid Redha Shirazi
• Masoud Shoukoohi, DMD
• Julie Goulding Shrewsbury, NP-C
• Daryl Silver, RN
• Carlee Elizabeth Silvers, RBT
• Melanie Silvers, OTR/L
• John Walton Simmons II, MD
• Megan Manning Sims, DPT

• Primary Podiatric Medicine Podiatrist in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Primary Podiatric Medicine Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.