NPIMap

Organization Active NPI

Village Podiatry Group LLC

  • Podiatrist
  • Fayetteville, GA
National Provider Identifier
1114665189
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
VILLAGE PODIATRY GROUP LLC
Practice address
1240 Highway 54 W Ste 312
Fayetteville, GA 30214-4563
Phone
(678) 426-2171
NPI assigned
May 20, 2022
Organization subpart
Yes
Parent organization
EXTREMITY HEALTHCARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Authorized official

Name
David N. Helfman, DPM
Title
Ceo
Phone
(678) 426-2171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

1240 Highway 54 W Ste 312
Fayetteville, GA 30214-4563

Mailing address

1350 Upper Hembree Rd Ste 100
Roswell, GA 30076-0929
Phone (678) 426-2171

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240625004139 GA DME Supplier - Physician - Podiatry 4587646971 Practice locations: Fayetteville, 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

Locations

1350 Upper Hembree Rd
Ste 100
Roswell, GA 30076
Phone (678) 426-2171

NPI Registry JSON

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653004800000",
    "number": "1114665189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 UPPER HEMBREE RD STE 100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300760929",
            "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": "1240 HIGHWAY 54 W STE 312",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144563",
            "telephone_number": "678-426-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE PODIATRY GROUP LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXTREMITY HEALTHCARE, INC.",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "HELFMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-426-2171",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; 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.