Organization Active NPI

Infinity Foot and Ankle Inc

  • Podiatric Clinic/Center
  • Loganville, GA
National Provider Identifier
1063203644
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
INFINITY FOOT AND ANKLE INC
Practice address
135 Lee Byrd Rd
Loganville, GA 30052-2310
Phone
(678) 639-4209
Fax
(678) 639-4210
NPI assigned
May 14, 2025
Last updated
May 14, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Authorized official

Name
Debra Phelps
Title
Manager
Phone
(678) 639-4209

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X NU Primary

Addresses

Primary practice location

135 Lee Byrd Rd
Loganville, GA 30052-2310

Mailing address

135 Lee Byrd Rd
Loganville, GA 30052-2310
Phone (678) 639-4209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250718000947 GA Part B Supplier - Clinic/Group Practice 6800302712 Receives reassigned benefits from 1 practitioner
Practice locations: Loganville, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1747180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747180800000",
    "number": "1063203644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 LEE BYRD RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522310",
            "telephone_number": "678-639-4209",
            "fax_number": "678-639-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 LEE BYRD RD",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522310",
            "telephone_number": "678-639-4209",
            "fax_number": "678-639-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITY FOOT AND ANKLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-14",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A",
        "authorized_official_last_name": "PHELPS",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "678-639-4209"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.