Tidewater Foot & Ankle Associates, Inc.

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

TIDEWATER FOOT & ANKLE ASSOCIATES, INC.

Practice address

4168 Woodlands Pkwy Ste B
Palm Harbor, FL 34685-3496

Phone

(813) 925-9431

NPI assigned

Aug 17, 2022

Organization subpart

No

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

Authorized official

Name

Megan Brook JohnsonNPI 1114211299

Title

Owner

Phone

(813) 925-9431

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Tidewater Foot & Ankle Associates, Inc.

  • Foot & Ankle Surgery Podiatrist
  • Palm Harbor, FL
  • NPI 1629573217

  1850646779

  Same PAC ID

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HFGEBD

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Megan Brook Johnson, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Palm Harbor, FL
  • NPI 1114211299
  NPD Authorized official
• Kyle Johnson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Palm Harbor, FL
  • NPI 1275824419
  NPD

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

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660694400000",
    "number": "1033837992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13019 W LINEBAUGH AVE STE 101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336264507",
            "telephone_number": "813-925-9431",
            "fax_number": "813-925-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4168 WOODLANDS PKWY STE B",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "346853496",
            "telephone_number": "813-925-9431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER FOOT & ANKLE ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-17",
        "last_updated": "2022-08-17",
        "certification_date": "2022-08-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_middle_name": "BROOK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-925-9431"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Thompson, M.D.
• Candace Nicole Thornburg
• Nicole Thornton, OTR
• Three Rooker Therapy
• Jaime Allison Tickett, BS
• Tidewater Foot & Ankle Associates, Inc.
• Tina Marie Tiernan, OTRL
• Douglas F Tight, PA
• Harriet Delores Tillman
• Timothy C. Runyon, DPM, PA

• Podiatrist in Palm Harbor, FL
• Providers in Palm Harbor, FL by specialty
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; 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.