Organization Active NPI

Dover Foot Care L.L.C.

  • Primary Podiatric Medicine Podiatrist
  • Dover, NJ
National Provider Identifier
1043377351
Registry record updated Apr 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
MD01886 Issued in NJ
Legal business name
DOVER FOOT CARE L.L.C.
Practice address
387 W Blackwell St
Dover, NJ 07801-2520
Phone
(973) 366-8000
Fax
(973) 442-1300
NPI assigned
Jan 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2009

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

Authorized official

Name
Ray Ivanovs, D.P.M.
Title
Owner
Phone
(973) 366-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213EP1101X MD01886 NJ Primary

Addresses

Primary practice location

387 W Blackwell St
Dover, NJ 07801-2520

Mailing address

387 W Blackwell St
Dover, NJ 07801-2520
Phone (973) 366-8000

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidNJ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240358400000",
    "number": "1043377351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "387 W BLACKWELL ST",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078012520",
            "telephone_number": "973-366-8000",
            "fax_number": "973-442-1300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "387 W BLACKWELL ST",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078012520",
            "telephone_number": "973-366-8000",
            "fax_number": "973-442-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOVER FOOT CARE L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-03",
        "last_updated": "2009-04-22",
        "status": "A",
        "authorized_official_last_name": "IVANOVS",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-366-8000",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NJ",
            "license": "MD01886",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; 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.