NPIMap

Organization Active NPI

Orlando Foot and Ankle Clinic, Inc

  • Foot & Ankle Surgery Podiatrist
  • Lake Mary, FL
National Provider Identifier
1114003274
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
ORLANDO FOOT AND ANKLE CLINIC, INC
Practice address
1307 S International Pkwy Ste 1061
Lake Mary, FL 32746-1412
Phone
(407) 323-1234
Fax
(407) 322-8523
NPI assigned
Oct 31, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Authorized official

Name
Gregory Renton
Title
Ceo
Phone
(407) 423-1234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

1307 S International Pkwy Ste 1061
Lake Mary, FL 32746-1412

Mailing address

P O Box 140233
Orlando, FL 32814-0233
Phone (407) 423-1234

Other identifiers 2

IdentifierTypeStateIssuer
DB3528OtherFLR/R MEDICARE
029602300MedicaidFL

Other names 1

  • Orlando Foot & Ankle Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040326000171 FL Part B Supplier - Clinic/Group Practice 6709778632 Receives reassigned benefits from 20 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Winter Park, FL; Winter Garden, FL; Saint Cloud, FL; Oviedo, FL; Orlando, FL; Ocoee, FL; Melbourne, FL; Lake Mary, FL…
O20100930005376 FL DME Supplier - Physician - Podiatry 6709778632 Practice locations: Lake Mary, FL

Other NPIs with the same Medicare PAC ID 13

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 13

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Foot Ankle Clinic12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1114003274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 140233",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328140233",
            "telephone_number": "407-423-1234",
            "fax_number": "407-517-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 S INTERNATIONAL PKWY STE 1061",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327461412",
            "telephone_number": "407-323-1234",
            "fax_number": "407-322-8523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORLANDO FOOT AND ANKLE CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-31",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A",
        "authorized_official_last_name": "RENTON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "407-423-1234"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE",
            "identifier": "DB3528",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029602300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orlando Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orlando Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Mary, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.