NPIMap

Organization Active NPI

Da Vinci Foot and Ankle LLC

  • Foot & Ankle Surgery Podiatrist
  • Greensboro, GA
National Provider Identifier
1164897971
Registry record updated Dec 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD001138 Issued in GA
Legal business name
DA VINCI FOOT AND ANKLE LLC
Practice address
1031 Village Park Dr
Suite 103
Greensboro, GA 30642-3755
Phone
(706) 999-9994
NPI assigned
Dec 4, 2015
Last updated
Dec 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2024

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

Authorized official

Name
Allison MenkeNPI 1457654899
Title
Sole Member
Phone
(706) 999-9994

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
Foot & Ankle Surgery Podiatrist 213ES0103X POD001138 GA Primary

Addresses

Primary practice location

1031 Village Park Dr
Suite 103
Greensboro, GA 30642-3755

Mailing address

1031 Village Park Dr.
Suite 103
Greensboro, GA 30642-6434
Phone (706) 999-9994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160203002988 GA Part B Supplier - Clinic/Group Practice 3072817519 Receives reassigned benefits from 1 practitioner
Practice locations: Greensboro, GA
O20160609002623 GA DME Supplier - Physician - Podiatry 3072817519 Practice locations: Greensboro, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1449187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733788800000",
    "number": "1164897971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 VILLAGE PARK DR.",
            "address_2": "SUITE 103",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306426434",
            "telephone_number": "706-999-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 VILLAGE PARK DR",
            "address_2": "SUITE 103",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306423755",
            "telephone_number": "706-999-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DA VINCI FOOT AND ANKLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-04",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A",
        "authorized_official_last_name": "MENKE",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "706-999-9994"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD001138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.