Organization Active NPI

Foot Centers of NC, PA

  • Foot & Ankle Surgery Podiatrist
  • Greensboro, NC
National Provider Identifier
1083854517
Registry record updated Feb 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
409 Issued in NC
Legal business name
FOOT CENTERS OF NC, PA
Practice address
5921 W Friendly Ave Ste D
Greensboro, NC 27410-3268
Phone
(336) 218-8490
Fax
(336) 768-3078
NPI assigned
Feb 24, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2019

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

Authorized official

Name
Karen Deborah De Jesus
Title
Management
Phone
(760) 200-8588

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 409 NC Primary

Addresses

Primary practice location

5921 W Friendly Ave Ste D
Greensboro, NC 27410-3268

Mailing address

76764 Lancelot CT
Palm Desert, CA 92211-7103
Phone (760) 200-8588

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1235433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550534400000",
    "number": "1083854517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76764 LANCELOT CT",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922117103",
            "telephone_number": "760-200-8588",
            "fax_number": "760-345-3609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5921 W FRIENDLY AVE STE D",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274103268",
            "telephone_number": "336-218-8490",
            "fax_number": "336-768-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT CENTERS OF NC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-24",
        "last_updated": "2019-02-19",
        "status": "A",
        "authorized_official_last_name": "DE JESUS",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "DEBORAH",
        "authorized_official_title_or_position": "MANAGEMENT",
        "authorized_official_telephone_number": "760-200-8588"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2019; 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.