Organization Active NPI

Essie M B Smith Foot Clinic

  • Podiatrist
  • Montgomery, AL
National Provider Identifier
1154562874
Registry record updated Oct 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
134 Issued in AL
Legal business name
ESSIE M B SMITH FOOT CLINIC
Practice address
201 Winton M Blount Loop
Montgomery, AL 36117-3507
Phone
(334) 271-3333
Fax
(334) 271-3768
NPI assigned
Mar 9, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2023

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

Authorized official

Name
Dr. Theresa Iola Brown, DPMNPI 1750409231
Title
Ceo/Owner
Phone
(334) 271-3333

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 134 AL Primary

Addresses

Primary practice location

201 Winton M Blount Loop
Montgomery, AL 36117-3507

Mailing address

201 Winton M Blount Loop # 126
Montgomery, AL 36117-3507
Phone (334) 271-3333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110316000413 AL DME Supplier - Physician - Podiatry 4486841723 Practice locations: Montgomery, AL
O20130613000290 AL Part B Supplier - Clinic/Group Practice 4486841723 Receives reassigned benefits from 1 practitioner
Practice locations: Montgomery, AL

National Provider Directory

National Provider Directory

Locations

3966 Atlanta Hwy
Montgomery, AL 36109
Phone (334) 271-4465

201 Winton M Blount Loop
#126
Montgomery, AL 36117

201 Winton M Blount Loop
Montgomery, AL 36117
Phone (334) 271-3333

348 Saint Lukes Dr
Montgomery, AL 36117
Phone (334) 271-3333

4319 Atlanta Hwy
Montgomery, AL 36109

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23191/brand/1/csg/1/fhir/r4

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": "1236556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1154562874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 WINTON M BLOUNT LOOP # 126",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173507",
            "telephone_number": "334-271-3333",
            "fax_number": "334-271-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 WINTON M BLOUNT LOOP",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173507",
            "telephone_number": "334-271-3333",
            "fax_number": "334-271-3768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSIE M B SMITH FOOT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-09",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "IOLA",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "334-271-3333",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "AL",
            "license": "134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.