Evolve Foot and Ankle

Primary specialty

PodiatristTaxonomy code 213E00000X

License

25MD00336100 Issued in NJ

Legal business name

EVOLVE FOOT AND ANKLE

Practice address

1529 Route 206 Ste L
Tabernacle, NJ 08088-8801

Phone

(856) 422-2323

Fax

(856) 872-4544

NPI assigned

May 24, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Urwah Haq, DPM

Title

Physician

Phone

(856) 422-2323

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1495584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1114455920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 468",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080530468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 ROUTE 206 STE L",
            "city": "TABERNACLE",
            "state": "NJ",
            "postal_code": "080888801",
            "telephone_number": "856-422-2323",
            "fax_number": "856-872-4544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "750 Route 73 S Ste 309A",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080534191",
            "country_code": "US",
            "telephone_number": "954-873-3438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EVOLVE FOOT AND ANKLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-24",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "HAQ",
        "authorized_official_first_name": "URWAH",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "856-422-2323",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NJ",
            "license": "25MD00336100",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Cimoch, PHARMD
• Sharlene Demartini-Guth, PSY.D.
• Erin Donoghue, PT, DPT
• Lauren Rose Ellis, PSY.D.
• Ernco Inc (Tabernacle Hometown Pharmacy Dept)
• Andrew John Fort, LPC
• Colin J Fort, DPT
• Katherine Amanda Fox
• Friends of Cyrus II Inc
• Friends of Cyrus II Inc

• Podiatrist in Tabernacle, NJ
• Providers in Tabernacle, NJ by specialty
• Podiatrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.