Footprint Podiatry Consultants, LLC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

PO1000031 Issued in DC

Legal business name

FOOTPRINT PODIATRY CONSULTANTS, LLC

Practice address

1328 Southern Ave SE
Suite 209
Washington, DC 20032-4689

Phone

(202) 506-1001

Fax

(202) 506-1008

NPI assigned

May 10, 2010

Organization subpart

Yes

Parent organization

FOOTPRINT PODIATRY CONSULTANTS, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Michangelo Darren Scruggs, DPM

Title

Podiatrist/Ceo

Phone

(202) 506-1001

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Footprint Podiatry Consultants, LLC Former legal business name

Part of

Footprint Podiatry Consultants LLC

Locations

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

{
    "created_epoch": "1273449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280707200000",
    "number": "1083932438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4316 18TH ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200114228",
            "telephone_number": "202-412-9664",
            "fax_number": "202-525-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 SOUTHERN AVE SE",
            "address_2": "SUITE 209",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324689",
            "telephone_number": "202-506-1001",
            "fax_number": "202-506-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTPRINT PODIATRY CONSULTANTS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOOTPRINT PODIATRY CONSULTANTS, LLC",
        "enumeration_date": "2010-05-10",
        "last_updated": "2010-08-02",
        "status": "A",
        "authorized_official_last_name": "SCRUGGS",
        "authorized_official_first_name": "MICHANGELO",
        "authorized_official_middle_name": "DARREN",
        "authorized_official_title_or_position": "PODIATRIST/CEO",
        "authorized_official_telephone_number": "202-506-1001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "DC",
            "license": "PO1000031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON",
            "identifier": "306106",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC/BS",
            "identifier": "947AMD-MD",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0000289842002",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "050785700",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC/BS",
            "identifier": "J892",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DC CHARTERED HEALTH",
            "identifier": "31290",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Footprint Podiatry Consultants, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Foot Specialists
• Adrianne Foote, MS SLP/CCC
• Maxwell Foote
• Dana Footer, PSYD
• Robert D Footer, MD
• For Eyes Optical of PA
• Clevert Forba
• Elizabeth Forba, PCA
• Sonita E Forba
• Atanga Cornelius Forbang

• Podiatric Clinic/Center in Washington, DC
• Providers in Washington, DC by specialty
• Podiatric Clinic/Center in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2010; 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.