Jla Senior Footcare Co LLC

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

700 Issued in CO

Legal business name

JLA SENIOR FOOTCARE CO LLC

Practice address

2101 S Garfield Ave
Loveland, CO 80537-7377

Phone

(330) 702-0978

NPI assigned

Sep 2, 2010

Organization subpart

No

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

Authorized official

Name

Anthony Innocenzi

Title

Owner

Phone

(330) 702-0978

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1283385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283385600000",
    "number": "1124335815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4870 S ASPEN CT",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444068469",
            "telephone_number": "330-702-0978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 S GARFIELD AVE",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805377377",
            "telephone_number": "330-702-0978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JLA SENIOR FOOTCARE CO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-02",
        "last_updated": "2010-09-02",
        "status": "A",
        "authorized_official_last_name": "INNOCENZI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-702-0978"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CO",
            "license": "700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

Verify at the official NPI Registry.