Clinton Foot & Ankle Clinic PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

5901000792 Issued in MI

Legal business name

CLINTON FOOT & ANKLE CLINIC PC

Practice address

1671 W Michigan Ave
Ste C-1
Clinton, MI 49236-8702

Phone

(517) 456-4114

Fax

(517) 456-4114

NPI assigned

Sep 13, 2006

Organization subpart

No

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

Authorized official

Name

Cheri Rose Derochie

Title

Billing Manager

Phone

(620) 615-6033

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Randolph Levitsky, DPM

  • Podiatrist
  • Clinton, MI
  • NPI 1841395183
  Medicare reassignment
• John Abbott, CRNA

  • Certified Registered Nurse Anesthetist
  • Traverse City, MI
  • NPI 1326004029
  NPD (past)

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1154426484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 0",
            "city": "CLINTON",
            "state": "MI",
            "postal_code": "492369502",
            "telephone_number": "517-456-4114",
            "fax_number": "517-456-4114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1671 W MICHIGAN AVE",
            "address_2": "STE C-1",
            "city": "CLINTON",
            "state": "MI",
            "postal_code": "492368702",
            "telephone_number": "517-456-4114",
            "fax_number": "517-456-4114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON FOOT & ANKLE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "DEROCHIE",
        "authorized_official_first_name": "CHERI",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "620-615-6033"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901000792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "5067480002",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Craig Brockman, N.P.
• Matthew David Bruce, D.O.
• Sherry Bumpus, NP
• Sita Chubukchian
• Grant Carson Clark, DC
• Lindsey Marjorie Creely, PT, DPT, ATC
• Kendra Crombez
• Paul Derheim
• Elysian Counseling, LLC
• Eos Psychotherapy, LLC

• Podiatrist in Clinton, MI
• Providers in Clinton, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; 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.