Active NPI
That Foot Doctor, LLC
- Podiatric Clinic/Center
- Allentown, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatric Clinic/Center
- License
- SC003851-L
- Legal business name
- THAT FOOT DOCTOR, LLC
- Practice address
- 1251 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103-6205 - Phone
- (610) 841-3535
- NPI assigned
- May 30, 2013
- Last updated
- Feb 16, 2015
- 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
- Dr. Michelle McCarroll, DPM
- Title
- Physician
- Phone
- (610) 841-3535
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatric Clinic/Center | 261QP1100X | SC003851-L | PA | Primary |
Addresses
Primary practice location
1251 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103-6205
Mailing address
1251 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103-6205
Phone (610) 841-3535
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15259880401 | Medicaid | PA |
National Provider Directory
National Provider Directory- Tax ID family
- Michelle McCarroll LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Foot Surgery Podiatrist
- Allentown, PA
- NPI 1730503723
Locations
1251 S Cedar Crest Blvd
Ste 301
Allentown, PA 18103
Phone (610) 437-0711
Interoperability endpoints
- https://api.platform.athenahealth.com/8281/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Foot & Ankle Surgery Podiatrist
- Allentown, PA
- NPI 1992780589
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369872000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1424044800000",
"number": "1134566292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1251 S CEDAR CREST BLVD",
"address_2": "STE 301",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181036205",
"telephone_number": "610-841-3535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1251 S CEDAR CREST BLVD",
"address_2": "STE 301",
"city": "ALLENTOWN",
"state": "PA",
"postal_code": "181036205",
"telephone_number": "610-841-3535"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THAT FOOT DOCTOR, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-05-30",
"last_updated": "2015-02-16",
"status": "A",
"authorized_official_last_name": "MCCARROLL",
"authorized_official_first_name": "MICHELLE",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "610-841-3535",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "261QP1100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Podiatric",
"state": "PA",
"license": "SC003851-L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "15259880401",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Allentown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 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.