Community Foot Center PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

5901000651 Issued in MI

Legal business name

COMMUNITY FOOT CENTER PC

Practice address

31450 7 Mile Rd
Livonia, MI 48152-1374

Phone

(248) 478-6363

Fax

(248) 478-9779

NPI assigned

Aug 31, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Gary Alan Wasiak, DPM

Title

President

Phone

(248) 478-6363

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251676800000",
    "number": "1144453770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2997 E HIGHLAND RD",
            "city": "HIGHLAND",
            "state": "MI",
            "postal_code": "483562811",
            "telephone_number": "248-887-3729",
            "fax_number": "248-889-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31450 7 MILE RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521374",
            "telephone_number": "248-478-6363",
            "fax_number": "248-478-9779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY FOOT CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-31",
        "last_updated": "2009-08-31",
        "status": "A",
        "authorized_official_last_name": "WASIAK",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-478-6363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901000651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1062554",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "5825393",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Livonia, MI
• Providers in Livonia, MI by specialty
• Foot & Ankle Surgery Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.