Ga Foot and Ankle Institute

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

885 Issued in GA

Legal business name

GA FOOT AND ANKLE INSTITUTE

Practice address

119 Canal St
Suite 106
Pooler, GA 31322-4095

Phone

(912) 355-6503

Fax

(912) 355-9837

NPI assigned

Feb 23, 2015

Organization subpart

Yes

Parent organization

GA FOOT AND ANKLE INSTITUTEAs reported in NPPES

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

Authorized official

Name

Kimberly Varner

Title

Practice Manager

Phone

(912) 355-6503

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Ga Foot Ankle Institute2 organizations share this tax ID, including this one

Part of

Ga Foot Ankle Institute

Other organizations with this tax ID 1

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

• Ga Foot and Ankle Institute

  • Foot & Ankle Surgery Podiatrist
  • Richmond Hill, GA
  • NPI 1922490366
  NPD tax ID

Locations

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424649600000",
    "number": "1104218544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 EISENHOWER DR",
            "address_2": "BUILDING 7A",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314062632",
            "telephone_number": "912-355-6503",
            "fax_number": "912-355-9837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 CANAL ST",
            "address_2": "SUITE 106",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224095",
            "telephone_number": "912-355-6503",
            "fax_number": "912-355-9837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GA FOOT AND ANKLE INSTITUTE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GA FOOT AND ANKLE INSTITUTE",
        "enumeration_date": "2015-02-23",
        "last_updated": "2015-02-23",
        "status": "A",
        "authorized_official_last_name": "VARNER",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "912-355-6503"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000880514",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Pooler, GA
• Providers in Pooler, GA by specialty
• Foot & Ankle Surgery Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2015; 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.