Prime Foot Care, PLLC – Podiatric Clinic/Center

Key facts

NPI: 1073557799
Entity type: Organization (NPI type 2)
Primary specialty: Podiatric Clinic/Center 261QP1100X
License: 80159 (MS)
Legal business name: PRIME FOOT CARE, PLLC
Practice address: 9065 Sandidge Center Cove
Ste C
Olive Branch, MS 38654-3574
Phone: (662) 893-0533
Fax: (662) 985-6821
NPI assigned: Jun 15, 2006
Organization subpart: No

Authorized official

Name: Dr. Carla Arnette Martin, DPM NPI 1255513230
Title: Podtiatrist
Phone: (662) 893-0533

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Carla Arnette Martin, D.P.M. Podiatrist · Olive Branch, MS · NPI 1255513230

Medicare reassignment NPD Authorized official MS · TN

Medicare participation

Medicare fee-for-service enrollment: Enrolled (2 enrollments) in MS, TN

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20140813000415	MS	Part B Supplier - Clinic/Group Practice	3678790706	Receives reassigned benefits from 1 practitioner Practice locations: Olive Branch, MS
O20200813000497	TN	Part B Supplier - Clinic/Group Practice	3678790706	Receives reassigned benefits from 1 practitioner Practice locations: Memphis, TN

National Provider Directory

Locations

9065 Sandidge Center Cv
Ste C
Olive Branch, MS 38654
Phone (662) 893-0533

9065 Sandidge Center Cv
Olive Branch, MS 38654
Phone (662) 892-8448

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Podiatric Clinic/Center	261QP1100X	80159	MS	Yes

Addresses

Primary practice location

9065 Sandidge Center Cove
Ste C
Olive Branch, MS 38654-3574

Mailing address

9065 Sandidge Center Cove
Ste C
Olive Branch, MS 38654-3574
Phone (662) 893-0533

Other names

DESOTO FOOT CARE Doing business as

Other providers in Olive Branch, MS

All providers in Olive Branch, MS · Podiatric Clinic/Center in Mississippi

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider 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.