Active NPI
Dover Foot Care L.L.C.
- Primary Podiatric Medicine Podiatrist
- Dover, NJ
National Provider Identifier
1043377351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Podiatric Medicine Podiatrist
- License
- MD01886
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Podiatric Medicine Podiatrist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | NJ |
National Provider Directory
National Provider DirectoryNPI 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.