NPIMap

Organization Active NPI

Midland Podiatry Associates PLLC

  • Podiatrist
  • Midland, MI
National Provider Identifier
1073849428
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
TL001607 Issued in MI
Legal business name
MIDLAND PODIATRY ASSOCIATES PLLC
Practice address
4911 Hedgewood Dr
Midland, MI 48640-1930
Phone
(989) 631-8200
Fax
(989) 631-5901
NPI assigned
Oct 20, 2009
Last updated
Dec 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Authorized official

Name
Mrs. Tammy L Bailer
Title
Office Manager
Phone
(989) 631-8200

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DS001126 MI
Podiatrist 213E00000X JS001702 MI
Podiatrist 213E00000X TL001607 MI Primary

Addresses

Primary practice location

4911 Hedgewood Dr
Midland, MI 48640-1930

Mailing address

4911 Hedgewood Dr
Midland, MI 48640-1930
Phone (989) 631-8200

Other names 1

  • David W. Snider, DPM Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100327000506 MI Part B Supplier - Clinic/Group Practice 7315073483 Receives reassigned benefits from 6 practitioners
Practice locations: Midland, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1255996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260921600000",
    "number": "1073849428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4911 HEDGEWOOD DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486401930",
            "telephone_number": "989-631-8200",
            "fax_number": "989-631-5901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4911 HEDGEWOOD DR",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486401930",
            "telephone_number": "989-631-8200",
            "fax_number": "989-631-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND PODIATRY ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-20",
        "last_updated": "2009-12-16",
        "status": "A",
        "authorized_official_last_name": "BAILER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "989-631-8200",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "DS001126",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "JS001702",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "TL001607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "David W. Snider, DPM",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.