Jackson Family Foot & Ankle Care, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

25MD00263900 Issued in NJ

Legal business name

JACKSON FAMILY FOOT & ANKLE CARE, LLC

Practice address

100 W Veterans Hwy
Suite 11
Jackson, NJ 08527-3435

Phone

(732) 833-6888

Fax

(732) 833-6280

NPI assigned

Jul 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Christopher Blakeslee, DPMNPI 1194799239

Title

Owner

Phone

(732) 833-6888

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Enrollment records 2

Locations

Practitioners 1

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

• Christopher H Blakeslee, D.P.M.

  • Podiatrist
  • Jackson, NJ
  • NPI 1194799239
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291939200000",
    "number": "1104025931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W VETERANS HWY",
            "address_2": "SUITE 11",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085273435",
            "telephone_number": "732-833-6888",
            "fax_number": "732-833-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W VETERANS HWY",
            "address_2": "SUITE 11",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085273435",
            "telephone_number": "732-833-6888",
            "fax_number": "732-833-6280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACKSON FAMILY FOOT & ANKLE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2010-12-10",
        "status": "A",
        "authorized_official_last_name": "BLAKESLEE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-833-6888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NJ",
            "license": "25MD00263900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9052801",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Interact Therapy Services, LLC
• Intrinsic Chiropractic Center
• Ivyrehab Network Inc
• Jackson Center for Foot and Ankle Medicine
• Jackson Center for Foot and Ankle Medicine,LLC
• Jackson Joint Ventures Limited Liability
• Jackson Orthodontics LLC
• Jackson Pediatric Dentistry PC
• Jackson Pharmacy Inc
• Jackson Surgical Center LLC

• Foot & Ankle Surgery Podiatrist in Jackson, NJ
• Providers in Jackson, NJ by specialty
• Foot & Ankle Surgery Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2010; 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.