Active NPI
Podcare
- Podiatrist
- Saint Clair Shores, MI
National Provider Identifier
1114239886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- SR400227
- Legal business name
- PODCARE
- Practice address
- 21327 Harper Ave
Suite C
Saint Clair Shores, MI 48080-2200 - Phone
- (989) 791-2455
- Fax
- (989) 791-2455
- NPI assigned
- Jul 9, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Steven Repitor, DPM
- Title
- Ceo
- Phone
- (989) 791-2455
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | SR400227 | MI | Primary |
Addresses
Primary practice location
21327 Harper Ave
Suite C
Saint Clair Shores, MI 48080-2200
Mailing address
3061 Christy Way
Saginaw, MI 48603-2267
Phone (989) 791-2455
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194760835 | Medicaid | MI |
National Provider Directory
National Provider Directory- Tax ID family
- Podcare
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Podiatrist
- Essexville, MI
- NPI 1003128778
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278633600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1278633600000",
"number": "1114239886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3061 CHRISTY WAY",
"city": "SAGINAW",
"state": "MI",
"postal_code": "486032267",
"telephone_number": "989-791-2455",
"fax_number": "989-791-1392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21327 HARPER AVE",
"address_2": "SUITE C",
"city": "SAINT CLAIR SHORES",
"state": "MI",
"postal_code": "480802200",
"telephone_number": "989-791-2455",
"fax_number": "989-791-2455"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PODCARE",
"organizational_subpart": "NO",
"enumeration_date": "2010-07-09",
"last_updated": "2010-07-09",
"status": "A",
"authorized_official_last_name": "REPITOR",
"authorized_official_first_name": "STEVEN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "989-791-2455",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "MI",
"license": "SR400227",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1194760835",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Saint Clair Shores, MI
- Jackie Placidi, MSW, LMSW
- Jennifer Plesz, M.A., CRC, LPC
- Julie Plichota
- Christine Marie Plichta
- Plymouth Physical Therapy Specialists Limited Partnership
- Pointes Allergy and Asthma Center, P.C.
- Pointes Plastic Surgery Associates P C
- Margaret M. Pokorski, P.T.
- Frank S Pollina, MD
- Ryan Christopher Pollina, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.