Samuel Winfred Person, D.P.M.

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

0103000377 Issued in VA

Practice address

2020 Wakefield Ave
Petersburg, VA 23805-2112

Phone

(804) 732-1211

Fax

(804) 733-5946

NPI assigned

May 27, 2005

Reactivated

Mar 22, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samuel.person@1430.chartlogic.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Personal Footcare LLC

  • Primary Podiatric Medicine Podiatrist
  • Petersburg, VA
  • NPI 1487613030
  Medicare reassignment NPD Authorized official
• Personal Footcare LLC

  • Durable Medical Equipment & Medical Supplies
  • South Hill, VA
  • NPI 1861746059
  NPD Authorized official

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154324879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 WAKEFIELD AVE",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238052112",
            "telephone_number": "804-732-1211",
            "fax_number": "804-733-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 WAKEFIELD AVE",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238052112",
            "telephone_number": "804-732-1211",
            "fax_number": "804-733-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSON",
        "first_name": "SAMUEL",
        "middle_name": "WINFRED",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2007-07-08",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "VA",
            "license": "0103000377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9331409",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Peoples Family Dental Care
• Douglas Bernard Peoples, DDS
• Raven Pepper
• Susan Woodford Perez, LCSW
• Taylor Perkinson
• Personal Foot Care Group
• Personal Foot Care II, LLC
• Personal Footcare LLC
• Petersburg Adult Healthcare
• Petersburg Case Management & Services

• Primary Podiatric Medicine Podiatrist in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Primary Podiatric Medicine Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.