Organization Active NPI

Southgate Foot and Ankle Center PLLC

  • Podiatric Clinic/Center
  • Southgate, MI
National Provider Identifier
1154391985
Registry record updated Mar 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
License
DZ400138 Issued in MI
Legal business name
SOUTHGATE FOOT AND ANKLE CENTER PLLC
Practice address
14535 Northline Rd.
Southgate, MI 48195-2446
Phone
(734) 285-4200
Fax
(734) 285-9256
NPI assigned
Jan 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2009

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

Authorized official

Name
Dr. Daniel T Zahari, DPMNPI 1487781712
Title
Doctor
Phone
(734) 285-4200

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
Podiatric Clinic/Center 261QP1100X DZ400138 MI Primary

Addresses

Primary practice location

14535 Northline Rd.
Southgate, MI 48195-2446

Mailing address

14535 Northline Rd.
Southgate, MI 48195-2446
Phone (734) 285-4200

Other identifiers 2

IdentifierTypeStateIssuer
DF6579OtherMIMEDICARE RETIRED RAILROAD
4390835MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070522000518 MI Part B Supplier - Clinic/Group Practice 0941307177 Receives reassigned benefits from 1 practitioner
Practice locations: Taylor, MI

National Provider Directory

National Provider Directory

Locations

14535 Northline Rd
Southgate, MI 48195
Phone (734) 285-4200

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": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236124800000",
    "number": "1154391985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14535 NORTHLINE RD.",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952446",
            "telephone_number": "734-285-4200",
            "fax_number": "734-285-9256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14535 NORTHLINE RD.",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952446",
            "telephone_number": "734-285-4200",
            "fax_number": "734-285-9256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHGATE FOOT AND ANKLE CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-24",
        "last_updated": "2009-03-04",
        "status": "A",
        "authorized_official_last_name": "ZAHARI",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "734-285-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "MI",
            "license": "DZ400138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RETIRED RAILROAD",
            "identifier": "DF6579",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4390835",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.