Dexter Podiatry, PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

5901002092 Issued in MI

Legal business name

DEXTER PODIATRY, PC

Practice address

7300 Dexter Ann Arbor Rd
Suite 100
Dexter, MI 48130-8598

Phone

(734) 253-2687

Fax

(734) 253-2697

NPI assigned

Jul 22, 2008

Last updated

Sep 21, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristi Ledbetter, D.P.M.

Title

President / Owner

Phone

(734) 253-2687

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253491200000",
    "number": "1043475726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 DEXTER ANN ARBOR RD",
            "address_2": "SUITE 100",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481308598",
            "telephone_number": "734-253-2687",
            "fax_number": "734-253-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 DEXTER ANN ARBOR RD",
            "address_2": "SUITE 100",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481308598",
            "telephone_number": "734-253-2687",
            "fax_number": "734-253-2697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEXTER PODIATRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2009-09-21",
        "status": "A",
        "authorized_official_last_name": "LEDBETTER",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "734-253-2687",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901002092",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043475726",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "48-0-H1-1754-0",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DP2242",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Paul A Diez, R.PH.
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• Stefani Luann Doody, DDS
• Dr. James K. Sommers, Inc, PC

• Foot & Ankle Surgery Podiatrist in Dexter, MI
• Providers in Dexter, MI by specialty
• Foot & Ankle Surgery Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 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.