NPIMap

Organization Active NPI

Laser Podiatry

  • Foot & Ankle Surgery Podiatrist
  • Germantown, MD
National Provider Identifier
1124498233
Registry record updated Oct 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
01423 Issued in MD
Legal business name
LASER PODIATRY
Practice address
19527 Doctors Dr
Germantown, MD 20874-5262
Phone
(301) 515-1494
NPI assigned
Oct 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2015

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

Authorized official

Name
Jennifer Mullendore, DPMNPI 1912902545
Title
Owner
Phone
(301) 515-1494

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 01423 MD Primary

Addresses

Primary practice location

19527 Doctors Dr
Germantown, MD 20874-5262

Mailing address

19527 Doctors Dr
Germantown, MD 20874-5262
Phone (301) 515-1494

National Provider Directory

National Provider Directory
Tax ID family
Laser Pod Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1443657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443657600000",
    "number": "1124498233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19527 DOCTORS DR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208745262",
            "telephone_number": "301-515-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19527 DOCTORS DR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208745262",
            "telephone_number": "301-515-1494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASER PODIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-10-01",
        "status": "A",
        "authorized_official_last_name": "MULLENDORE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-515-1494",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": "01423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2015; 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.