NPIMap

Organization Active NPI

Trussville Foot Care Center PC

  • Podiatrist
  • Birmingham, AL
National Provider Identifier
1043456254
Registry record updated Dec 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
209 Issued in AL
Legal business name
TRUSSVILLE FOOT CARE CENTER PC
Practice address
1930 Edwards Lake Rd
Suite 138
Birmingham, AL 35235-3718
Phone
(205) 661-1400
NPI assigned
Dec 18, 2008
Last updated
Dec 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2008

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

Authorized official

Name
David Anderson, DPM
Title
Owner
Phone
(205) 661-1400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 209 AL Primary

Addresses

Primary practice location

1930 Edwards Lake Rd
Suite 138
Birmingham, AL 35235-3718

Mailing address

1930 Edwards Lake Rd
Suite 138
Birmingham, AL 35235-3718
Phone (205) 661-1400

Other identifiers 1

IdentifierTypeStateIssuer
529906320MedicaidAL

National Provider Directory

National Provider Directory

Locations

1930 Edwards Lake Rd
Ste 1
Birmingham, AL 35235

NPI Registry JSON

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

{
    "created_epoch": "1229558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229558400000",
    "number": "1043456254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 EDWARDS LAKE RD",
            "address_2": "SUITE 138",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353718",
            "telephone_number": "205-661-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 EDWARDS LAKE RD",
            "address_2": "SUITE 138",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352353718",
            "telephone_number": "205-661-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUSSVILLE FOOT CARE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-18",
        "last_updated": "2008-12-18",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-661-1400",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AL",
            "license": "209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529906320",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2008; 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.