Southeastern Foot & Ankle Associates, PA

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

465 Issued in NC

Legal business name

SOUTHEASTERN FOOT & ANKLE ASSOCIATES, PA

Practice address

920 S 17TH St
Wilmington, NC 28401-8022

Phone

(910) 763-7578

Fax

(910) 763-9320

NPI assigned

Mar 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert McConekey, DPM

Title

Owner

Phone

(910) 763-7578

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Practitioners 1

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

• Carine Marie Khouri, DPM

  • Primary Podiatric Medicine Podiatrist
  • Wilmington, NC
  • NPI 1801074588
  Medicare reassignment NPD

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377820800000",
    "number": "1154450393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284018022",
            "telephone_number": "910-763-7578",
            "fax_number": "910-763-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284018022",
            "telephone_number": "910-763-7578",
            "fax_number": "910-763-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHEASTERN FOOT & ANKLE ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2013-08-30",
        "status": "A",
        "authorized_official_last_name": "MCCONEKEY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "910-763-7578",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NC",
            "license": "465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890808U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "2332798",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mollie-Williams Moss Southard, LCSW
• Shirley W Southard
• Southcare Community Service, Inc
• Southcare Minute Clinic Inc
• Southeast Anesthesiology Consultants, PLLC
• Southeastern Foot Associates PA
• Southeastern Healthcare Center PC
• Southeastern Healthcare Centers PC
• Southeastern Healthcare Centers PC
• Southeastern Healthcare of Monkey Junction PC

• Podiatric Clinic/Center in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Podiatric Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2013; 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.