Organization Active NPI

Doctor Foot Care, PLLC

  • Podiatrist
  • Charlotte, NC
National Provider Identifier
1174212229
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
DOCTOR FOOT CARE, PLLC
Practice address
1325 Braeburn Rd
Charlotte, NC 28211-4770
Phone
(646) 427-1422
NPI assigned
May 4, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Authorized official

Name
Dr. Ida M Lim, DPMNPI 1013409051
Title
Owner, Podiatrist
Phone
(646) 427-1422

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 Primary

Addresses

Primary practice location

1325 Braeburn Rd
Charlotte, NC 28211-4770

Mailing address

10020 Monroe Rd
Suite 170 - 127
Matthews, NC 28105
Phone (980) 737-3957

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230822001448 NC Part B Supplier - Clinic/Group Practice 4486016557 Receives reassigned benefits from 2 practitioners
Practice locations: Charlotte, NC

National Provider Directory

National Provider Directory

Locations

10020 Monroe Rd
Ste 170
Matthews, NC 28105

10020 Monroe Rd
Ste 170127
Matthews, NC 28105

10010 Monroe Rd Ste 170127
Matthews, NC 28105

Practitioners & affiliated clinicians

Practitioners 2

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": "1683158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1174212229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10020 MONROE RD",
            "address_2": "SUITE 170 - 127",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "28105",
            "telephone_number": "980-737-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 BRAEBURN RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282114770",
            "telephone_number": "646-427-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOCTOR FOOT CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-04",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "LIM",
        "authorized_official_first_name": "IDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER, PODIATRIST",
        "authorized_official_telephone_number": "646-427-1422",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.