NPIMap

Organization Active NPI

Charlotte County Foot Clinics LLC

  • Podiatrist
  • Port Charlotte, FL
National Provider Identifier
1073059507
Registry record updated Jan 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO3373 Issued in FL
Legal business name
CHARLOTTE COUNTY FOOT CLINICS LLC
Practice address
2866 Tamiami TRL
Ste C
Port Charlotte, FL 33952-5126
Phone
(941) 629-3535
Fax
(941) 625-2076
NPI assigned
Jan 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2017

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

Authorized official

Name
Mike A Bush
Title
Manager
Phone
(954) 479-0481

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X PO3373 FL Primary

Addresses

Primary practice location

2866 Tamiami TRL
Ste C
Port Charlotte, FL 33952-5126

Mailing address

2866 Tamiami TRL
Ste C
Port Charlotte, FL 33952-5126
Phone (941) 629-3535

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1483833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483833600000",
    "number": "1073059507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2866 TAMIAMI TRL",
            "address_2": "STE C",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525126",
            "telephone_number": "941-629-3535",
            "fax_number": "941-625-2076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2866 TAMIAMI TRL",
            "address_2": "STE C",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339525126",
            "telephone_number": "941-629-3535",
            "fax_number": "941-625-2076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE COUNTY FOOT CLINICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-08",
        "last_updated": "2017-01-08",
        "status": "A",
        "authorized_official_last_name": "BUSH",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "954-479-0481"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO3373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2017; 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.