Organization Active NPI

Seacoast Foot Surgery Assoc

  • Podiatrist
  • Portsmouth, NH
National Provider Identifier
1174600217
Registry record updated Jan 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0183 Issued in NH
Legal business name
SEACOAST FOOT SURGERY ASSOC
Practice address
330 Borthwick Avenue
Suite 112
Portsmouth, NH 03801
Phone
(603) 430-8505
Fax
(603) 436-8381
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2011

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

Authorized official

Name
Roxanne Raeside Wilton, CAPPM EFPM CPODCS
Title
Practice Administrator
Phone
(603) 430-8505

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X 0183 NH Primary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X POD212 ME

Addresses

Primary practice location

330 Borthwick Avenue
Suite 112
Portsmouth, NH 03801

Mailing address

330 Borthwick Avenue
Suite 112
Portsmouth, NH 03801
Phone (603) 430-8505

Other identifiers 1

IdentifierTypeStateIssuer
40368267MedicaidNH

National Provider Directory

National Provider Directory

Locations

330 Borthwick Ave
Ste 112
Portsmouth, NH 03801
Phone (603) 430-8505

Practitioners & affiliated clinicians

Practitioners 1

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": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294272000000",
    "number": "1174600217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BORTHWICK AVENUE",
            "address_2": "SUITE 112",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03801",
            "telephone_number": "603-430-8505",
            "fax_number": "603-436-8381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BORTHWICK AVENUE",
            "address_2": "SUITE 112",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "03801",
            "telephone_number": "603-430-8505",
            "fax_number": "603-436-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEACOAST FOOT SURGERY ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-01-06",
        "status": "A",
        "authorized_official_last_name": "RAESIDE WILTON",
        "authorized_official_first_name": "ROXANNE",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "603-430-8505",
        "authorized_official_credential": "CAPPM EFPM CPODCS"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "NH",
            "license": "0183",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "ME",
            "license": "POD212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40368267",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.