NPIMap

Organization Active NPI

Instride Foot and Ankle Specialists, PLLC

  • Primary Podiatric Medicine Podiatrist
  • King, NC
National Provider Identifier
1063390862
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
Legal business name
INSTRIDE FOOT AND ANKLE SPECIALISTS, PLLC
Practice address
119 Ingram Dr
King, NC 27021-8205
Phone
(336) 443-9190
NPI assigned
Aug 21, 2025
Last updated
Oct 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Authorized official

Name
Eldon PetersNPI 1588071484
Title
Vice President
Phone
(919) 829-0076

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X Primary
Foot & Ankle Surgery Podiatrist 213ES0103X
Foot Surgery Podiatrist 213ES0131X

Addresses

Primary practice location

119 Ingram Dr
King, NC 27021-8205

Mailing address

1036 Branchview Dr Ste 216
Concord, NC 28025-0113
Phone (704) 886-1918

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250917000507 NC DME Supplier - Physician - Podiatry 7012168271 Practice locations: King, NC

Other NPIs with the same Medicare PAC ID 21

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 21

National Provider Directory

National Provider Directory
Tax ID family
Instride Foot Ankle Specia24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

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

View all 23

Locations

143 N 3rd St
Albemarle, NC 28001
Phone (704) 786-4482

1031 W Williams St
Ste 105A
Apex, NC 27502
Phone (919) 363-3310

6831 Fairview Rd
Ste A
Charlotte, NC 28210
Phone (704) 364-2151

8912 Blakeney Professional Dr
Ste A2
Charlotte, NC 28277
Phone (704) 544-6517

9216 Ardrey Kell Rd
Ste 100
Charlotte, NC 28277
Phone (704) 455-6517

4119 Capitol St
Durham, NC 27704
Phone (919) 294-8621

251 Wilmot Dr
Gastonia, NC 28054
Phone (704) 861-0425

603 Cox Rd
Gastonia, NC 28054
Phone (704) 852-9561

530 N Elam Ave
Ste B
Greensboro, NC 27403
Phone (336) 299-0271

451 Ruin Creek Rd
Ste 202
Henderson, NC 27536
Phone (252) 438-4425

123 Pompano Pl
Ste 500
Jacksonville, NC 28546
Phone (910) 939-3668

1514 Glenwood Ave
Raleigh, NC 27608
Phone (919) 619-7310

7920 Acc Blvd
Ste 100A
Raleigh, NC 27617
Phone (919) 533-4200

611 Mocksville Ave
Ste 200
Salisbury, NC 28144
Phone (980) 892-5200

520 N Broome St
Waxhaw, NC 28173
Phone (704) 243-7844

528 Broome St
Waxhaw, NC 28173
Phone (704) 243-7844

1 Medical Park Dr
#3
Chester, SC 29706
Phone (800) 336-1279

700 N A St
Easley, SC 29640
Phone (864) 232-3668

2236 E Highway 76
#B
Marion, SC 29571
Phone (843) 423-4044

2845 E Highway 76
Mullins, SC 29574
Phone (843) 431-2740

Practitioners & affiliated clinicians

Practitioners 52

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.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1755734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759968000000",
    "number": "1063390862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 BRANCHVIEW DR STE 216",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "280250113",
            "telephone_number": "704-886-1918",
            "fax_number": "704-257-2049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 INGRAM DR",
            "city": "KING",
            "state": "NC",
            "postal_code": "270218205",
            "telephone_number": "336-443-9190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTRIDE FOOT AND ANKLE SPECIALISTS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-21",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A",
        "authorized_official_last_name": "PETERS",
        "authorized_official_first_name": "ELDON",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "919-829-0076"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in King, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.