NPIMap

Organization Active NPI

Foot and Ankle Specialists of the Mid Atlantic LLC

  • Non-Pharmacy Dispensing Site
  • Lake Ridge, VA
National Provider Identifier
1063306132
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC
Practice address
1721 Financial Loop
Lake Ridge, VA 22192-2460
Phone
(703) 491-9500
NPI assigned
Jun 4, 2025
Last updated
Jun 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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

Authorized official

Name
Rosalie Kreighbaum
Title
Regional Credentialing Specialist
Phone
(314) 909-1920

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X NU Primary

Addresses

Primary practice location

1721 Financial Loop
Lake Ridge, VA 22192-2460

Mailing address

PO Box 825159
Philadelphia, PA 19182-5159

National Provider Directory

National Provider Directory
Tax ID family
Foot and Ankle Specialists of the Mid Atlantic LLC98 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1748995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748995200000",
    "number": "1063306132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825159",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191825159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 FINANCIAL LOOP",
            "city": "LAKE RIDGE",
            "state": "VA",
            "postal_code": "221922460",
            "telephone_number": "703-491-9500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-04",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A",
        "authorized_official_last_name": "KREIGHBAUM",
        "authorized_official_first_name": "ROSALIE",
        "authorized_official_title_or_position": "REGIONAL CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "314-909-1920"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Ridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; 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.