Magnolia Green Foot and Ankle Center LLC

Primary specialty

Orthopaedic Foot and Ankle Surgery PhysicianTaxonomy code 207XX0004X

Legal business name

MAGNOLIA GREEN FOOT AND ANKLE CENTER LLC

Practice address

6055 Harbour Park Dr
Midlothian, VA 23112-2160

Phone

(804) 500-0949

Fax

(804) 500-0946

NPI assigned

Jun 10, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Jungmin YooNPI 1558752485

Title

Ceo

Phone

(804) 500-0949

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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.

• Jungmin Yoo

  • Foot & Ankle Surgery Podiatrist
  • Midlothian, VA
  • NPI 1558752485
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690416000000",
    "number": "1093382681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6055 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122160",
            "telephone_number": "804-500-0949",
            "fax_number": "804-500-0946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6055 HARBOUR PARK DR",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122160",
            "telephone_number": "804-500-0949",
            "fax_number": "804-500-0946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA GREEN FOOT AND ANKLE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-10",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A",
        "authorized_official_last_name": "YOO",
        "authorized_official_first_name": "JUNGMIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "804-500-0949",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207XX0004X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Foot and Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jazmin Ileana Macias, PHARMD
• Rebecca Mackall, M.S. CCC-SLP
• Stephanie Lynn Mackey, M.ED.
• Claire Magill
• Magnolia Family Dental
• Lori Magnuson, P.T.
• Katrina Mai Mah, DC
• Emily Mahaffey, DPT, CLT
• Snehal Manmeet Mahajan
• Mallika Maheepathi

• Orthopaedic Foot and Ankle Surgery Physician in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Orthopaedic Foot and Ankle Surgery Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.