Foot and Ankle Specialist of Georgia, LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

POD001225 Issued in GA

Legal business name

FOOT AND ANKLE SPECIALIST OF GEORGIA, LLC

Practice address

3400 Chapel Hill Rd
Suite 321
Douglasville, GA 30135-1739

Phone

(678) 741-5346

Fax

(678) 999-3030

NPI assigned

Nov 2, 2015

Last updated

Nov 2, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tamala Walton, DPM

Title

Owner

Phone

(404) 933-4291

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

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.

• Tamala Walton-Sampson, D.P.M

  • Podiatrist
  • Rome, GA
  • NPI 1326350075
  Medicare reassignment NPD

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

{
    "created_epoch": "1446422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446422400000",
    "number": "1063885929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 CHAPEL HILL RD",
            "address_2": "SUITE 321",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351739",
            "telephone_number": "678-741-5346",
            "fax_number": "678-999-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 CHAPEL HILL RD",
            "address_2": "SUITE 321",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351739",
            "telephone_number": "678-741-5346",
            "fax_number": "678-999-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE SPECIALIST OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-02",
        "last_updated": "2015-11-02",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "TAMALA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-933-4291",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD001225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003138997C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raymond P Flowers III, D.O.
• Thomas Flowers, RBT
• Santana Floyd Gowdy
• Tommie Joann Floyd, A.P.N.
• Kiersten Fluellen
• Gregory Raymon Ford Jr.
• Tyrique Ford, RBT
• Zebulon Foreman, NP
• Kaalin D Former
• Ashton Brooke Foster, PAC

• Podiatrist in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2015; 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.