NPIMap

Organization Active NPI

Magnolia Podiatry Associates PA

  • Foot & Ankle Surgery Podiatrist
  • Tamarac, FL
National Provider Identifier
1033317995
Registry record updated Dec 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO3137 Issued in FL
Legal business name
MAGNOLIA PODIATRY ASSOCIATES PA
Practice address
7727 Southampton Ter
Suite 412-F
Tamarac, FL 33321-9101
Phone
(954) 721-6010
NPI assigned
Jul 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2011

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

Authorized official

Name
Dr. Edward L Weiner, D.P.M.NPI 1518929991
Title
President
Phone
(954) 721-6010

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 PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X PO3137 FL Primary

Addresses

Primary practice location

7727 Southampton Ter
Suite 412-F
Tamarac, FL 33321-9101

Mailing address

7727 Southampton Ter
Suite 412-F
Tamarac, FL 33321-9101
Phone (954) 721-6010

Other identifiers 1

IdentifierTypeStateIssuer
340507900MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325203200000",
    "number": "1033317995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7727 SOUTHAMPTON TER",
            "address_2": "SUITE 412-F",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333219101",
            "telephone_number": "954-721-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7727 SOUTHAMPTON TER",
            "address_2": "SUITE 412-F",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333219101",
            "telephone_number": "954-721-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA PODIATRY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2011-12-30",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "954-721-6010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "340507900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tamarac, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.