Individual provider Active NPI

Ann Wolford, DPM

  • Foot & Ankle Surgery Podiatrist
  • Kingsport, TN
National Provider Identifier
1093085367
Registry record updated Jul 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
DPM0000000884 Issued in TN
Practice address
1 Sheridan SQ Ste 102
Kingsport, TN 37660-7398
Phone
(423) 722-5200
NPI assigned
Jan 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 2015040981 MO
Foot & Ankle Surgery Podiatrist 213ES0103X 252471 KY
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X DPM0000000884 TN Primary

Addresses

Primary practice location

1 Sheridan SQ Ste 102
Kingsport, TN 37660-7398

Mailing address

1 Sheridan SQ Ste 102
Kingsport, TN 37660-7398
Phone (423) 722-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210813000301 TN Practitioner - Podiatry 5294036612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Tennessee Podiatry Associates PLLCGroup PAC ID 5597169599, 2 clinicians

Practice addresses (Care Compare)

1 Sheridan SQ
Suite 102
Kingsport, TN 37660-7398
Phone (423) 722-5200

Hospital & facility affiliations

  • Wellmont Holston Valley Medical Center Hospital, Kingsport, TN, CCN 440017

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue15
Removal of nail tissue126
Removal or shaving of skin growth45

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2015040981MOMDFoot & Ankle Surgery Podiatrist
DPM0000000884TNMDFoot & Ankle Surgery Podiatrist
884TNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Podiatry Associates PLLC Foot & Ankle Surgery CurrentSince Aug 2, 2021 Accepting new patients

Locations

1 Sheridan Sq
Ste 102
Kingsport, TN 37660
Phone (423) 722-5200

Interoperability endpoints

  • Direct secure messaging: ann.wolford.1@24365.direct.athenahealth.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627516800000",
    "number": "1093085367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SHERIDAN SQ STE 102",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607398",
            "telephone_number": "423-722-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SHERIDAN SQ STE 102",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376607398",
            "telephone_number": "423-722-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFORD",
        "first_name": "ANN",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2021-07-29",
        "certification_date": "2021-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2015040981",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "KY",
            "license": "252471",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TN",
            "license": "DPM0000000884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.