Ankle and Foot Clinic of Georgia, Inc.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

ANKLE AND FOOT CLINIC OF GEORGIA, INC.

Practice address

730 Lanier Ave W
Fayetteville, GA 30214-1509

Phone

(770) 460-5064

Fax

(770) 460-0838

NPI assigned

Feb 1, 2013

Last updated

Feb 1, 2013By 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. Roberta J Parker, D.P.M.NPI 1043288459

Title

President

Phone

(770) 460-5064

Specialties & licenses 1

Addresses

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.

• Roberta Jean Parker, DPM

  • Podiatrist
  • Fayetteville, GA
  • NPI 1043288459
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1359676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359676800000",
    "number": "1073852786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 LANIER AVE W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141509",
            "telephone_number": "770-460-5064",
            "fax_number": "770-460-0838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 LANIER AVE W",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141509",
            "telephone_number": "770-460-5064",
            "fax_number": "770-460-0838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANKLE AND FOOT CLINIC OF GEORGIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-01",
        "last_updated": "2013-02-01",
        "status": "A",
        "authorized_official_last_name": "PARKER",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-460-5064",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Foot & Ankle Surgery Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2013; 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.