NPIMap

Organization Active NPI

Village Podiatry Group, LLC.

  • Podiatrist
  • Acworth, GA
National Provider Identifier
1104203710
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
VILLAGE PODIATRY GROUP, LLC.
Practice address
4450 Calibre Crossing NW
Suite #1130
Acworth, GA 30101-4104
Phone
(770) 943-8809
Fax
(770) 943-8809
NPI assigned
May 4, 2015
Last updated
Jul 18, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
EXTREMITY HEALTHCARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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

Authorized official

Name
David N. Helfman, D.P.M.
Title
C.E.O.
Phone
(678) 426-2171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X Primary

Addresses

Primary practice location

4450 Calibre Crossing NW
Suite #1130
Acworth, GA 30101-4104

Mailing address

900 Circle 75 Pkwy.
Ste. 900
Atlanta, GA 30339-3084
Phone (678) 426-2171

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151117003214 GA DME Supplier - Physician - Podiatry 4587646971 Practice locations: Acworth, GA

National Provider Directory

National Provider Directory
Tax ID family
Village Podiatry Group LLC35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468800000000",
    "number": "1104203710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CIRCLE 75 PKWY.",
            "address_2": "STE. 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393084",
            "telephone_number": "678-426-2171",
            "fax_number": "404-446-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4450 CALIBRE CROSSING NW",
            "address_2": "SUITE #1130",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301014104",
            "telephone_number": "770-943-8809",
            "fax_number": "770-943-8809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE PODIATRY GROUP, LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXTREMITY HEALTHCARE, INC.",
        "enumeration_date": "2015-05-04",
        "last_updated": "2016-07-18",
        "status": "A",
        "authorized_official_last_name": "HELFMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "678-426-2171",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; 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.