Organization Active NPI

Country Foot Care Podiatry PLLC

  • Foot & Ankle Surgery Podiatrist
  • Mineola, NY
National Provider Identifier
1053776096
Registry record updated Dec 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
COUNTRY FOOT CARE PODIATRY PLLC
Practice address
173 Mineola Blvd
Suite 201
Mineola, NY 11501-2528
Phone
(516) 741-3338
Fax
(516) 506-7123
NPI assigned
Dec 17, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2015

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

Authorized official

Name
Steven D Brook, DPM
Title
Owner
Phone
(516) 741-3338

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

173 Mineola Blvd
Suite 201
Mineola, NY 11501-2528

Mailing address

173 Mineola Blvd
Suite 201
Mineola, NY 11501-2528
Phone (516) 741-3338

National Provider Directory

National Provider Directory
Tax ID family
Country Foot Care Podiatry3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

173 Mineola Blvd
Ste 201
Mineola, NY 11501
Phone (516) 741-3338

NPI Registry JSON

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1053776096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 MINEOLA BLVD",
            "address_2": "SUITE 201",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012528",
            "telephone_number": "516-741-3338",
            "fax_number": "516-506-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 MINEOLA BLVD",
            "address_2": "SUITE 201",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115012528",
            "telephone_number": "516-741-3338",
            "fax_number": "516-506-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY FOOT CARE PODIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-17",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "BROOK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-741-3338",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mineola, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; 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.