NPIMap

Organization Active NPI

Mark a Lazar DPM PC

Doing business as Greenwood Foot Clinic

  • Foot & Ankle Surgery Podiatrist
  • Greenwood, IN
National Provider Identifier
1033315346
Registry record updated Jun 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
07000591 Issued in IN
Legal business name
MARK A LAZAR DPM PC
Doing business as
Greenwood Foot Clinic
Practice address
720 Fry Rd
Ste. a
Greenwood, IN 46142-2410
Phone
(317) 881-0788
Fax
(317) 889-0775
NPI assigned
Jun 23, 2007
Last updated
Jun 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2015

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

Authorized official

Name
Dr. Mark A Lazar, DPMNPI 1710907381
Title
Owner
Phone
(317) 881-0788

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 07000591 IN Primary

Addresses

Primary practice location

720 Fry Rd
Ste. a
Greenwood, IN 46142-2410

Mailing address

720 Fry Rd
Ste. a
Greenwood, IN 46142-2410
Phone (317) 881-0788

Other identifiers 1

IdentifierTypeStateIssuer
200185200AMedicaidIN

Other names 1

  • Greenwood Foot Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

720 Fry Rd
Ste A
Greenwood, IN 46142
Phone (317) 881-0788

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1182556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1033315346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 FRY RD",
            "address_2": "STE. A",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461422410",
            "telephone_number": "317-881-0788",
            "fax_number": "317-889-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 FRY RD",
            "address_2": "STE. A",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461422410",
            "telephone_number": "317-881-0788",
            "fax_number": "317-889-0775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A LAZAR DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-23",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "LAZAR",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-881-0788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07000591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200185200A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenwood Foot Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.