Active NPI
Satilla Foot and Ankle, LLC
- Foot & Ankle Surgery Podiatrist
- Waycross, GA
National Provider Identifier
1063777340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- POD001151
- Legal business name
- SATILLA FOOT AND ANKLE, LLC
- Practice address
- 545 Knight Ave
Waycross, GA 31501-3354 - Phone
- (912) 490-3668
- NPI assigned
- Jul 12, 2012
- Last updated
- Aug 10, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Leslie B Dowling, DPM
- Title
- Doctor / Owner
- Phone
- (912) 490-3668
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | POD001151 | GA | Primary |
Addresses
Primary practice location
545 Knight Ave
Waycross, GA 31501-3354
Mailing address
545 Knight Ave
Waycross, GA 31501-3354
Phone (912) 490-3668
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003126292B | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 2
National Provider Directory
National Provider Directory- Tax ID family
- Satilla Foot and Ankle LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Foot & Ankle Surgery Podiatrist
- Waycross, GA
- NPI 1184555211
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/EIFBDA
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Foot & Ankle Surgery Podiatrist
- Waycross, GA
- NPI 1184555211
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Foot & Ankle Surgery Podiatrist
- Waycross, GA
- NPI 1699044529
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342051200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1470787200000",
"number": "1063777340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "545 KNIGHT AVE",
"city": "WAYCROSS",
"state": "GA",
"postal_code": "315013354",
"telephone_number": "912-490-3668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "545 KNIGHT AVE",
"city": "WAYCROSS",
"state": "GA",
"postal_code": "315013354",
"telephone_number": "912-490-3668"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SATILLA FOOT AND ANKLE, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-07-12",
"last_updated": "2016-08-10",
"status": "A",
"authorized_official_last_name": "DOWLING",
"authorized_official_first_name": "LESLIE",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "DOCTOR / OWNER",
"authorized_official_telephone_number": "912-490-3668",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "GA",
"license": "POD001151",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "003126292B",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waycross, GA
- Sareyan, LLC (Satilla Wellness Pharmacy)
- Satilla Life Care
- Satilla Cancer Treatment Centers, LLC (CurePoint)
- Satilla Cancer Treatment Centers, LLC (CurePoint)
- Satilla Family Medicine, P.C.
- Satilla Foot and Ankle, LLC
- Satilla Health Management Inc (Satilla Convenient Care)
- Satilla Reliant Psychiatric Services, LLC (Satilla Regional Center for Memory Disorders)
- Satilla Rheumatology and Internal Medicine, PC
- Satilla Spine Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.