NPIMap

Organization Active NPI

Podiatry Associates of Victoria PA

  • Primary Podiatric Medicine Podiatrist
  • Victoria, TX
National Provider Identifier
1174505358
Registry record updated Mar 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
Legal business name
PODIATRY ASSOCIATES OF VICTORIA PA
Practice address
116 Imperial Dr
Victoria, TX 77901-3948
Phone
(361) 578-2777
Fax
(361) 578-2778
NPI assigned
Nov 15, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2008

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

Authorized official

Name
Dr. Maureen Leigh Caldwell, DPMNPI 1568464634
Title
Doctor
Phone
(361) 578-2777

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213EP1101X Primary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X

Addresses

Primary practice location

116 Imperial Dr
Victoria, TX 77901-3948

Mailing address

116 Imperial Dr
Victoria, TX 77901-3948
Phone (361) 578-2777

Other identifiers 2

IdentifierTypeStateIssuer
DB9630OtherTXRAILROAD MEDICARE GROUP
00920KOtherTXBCBS GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041104001049 TX Part B Supplier - Clinic/Group Practice 9830152438 Receives reassigned benefits from 4 practitioners
Practice locations: Victoria, TX; Refugio, TX; Port Lavaca, TX
O20100930007849 TX DME Supplier - Physician - Podiatry 9830152438 Practice locations: Victoria, TX

National Provider Directory

National Provider Directory

Locations

1801 N Frontage Rd
Beeville, TX 78102

506 E San Antonio St
Fl 3
Victoria, TX 77901
Phone (361) 575-1445

116 Imperial Dr
Victoria, TX 77901

2710 Hospital Dr
Victoria, TX 77901
Phone (361) 575-0636

Practitioners & affiliated clinicians

Practitioners 7

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": "1132012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1174505358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 IMPERIAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779013948",
            "telephone_number": "361-578-2777",
            "fax_number": "361-578-2778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 IMPERIAL DR",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779013948",
            "telephone_number": "361-578-2777",
            "fax_number": "361-578-2778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY ASSOCIATES OF VICTORIA PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-15",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "MAUREEN",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "361-578-2777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DB9630",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "00920K",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Victoria, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; 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.