Organization Active NPI

Unifour Podiatry, PLLC

  • Podiatrist
  • Hickory, NC
National Provider Identifier
1174751960
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
430 Issued in NC
Legal business name
UNIFOUR PODIATRY, PLLC
Practice address
912 2ND St NE
Hickory, NC 28601-3851
Phone
(828) 267-1916
Fax
(828) 267-1922
NPI assigned
Jun 30, 2009
Last updated
Jun 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Authorized official

Name
Dr. John Henry Grogan III, DPMNPI 1326006727
Title
Owner
Phone
(828) 267-1916

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
Podiatrist 213E00000X 430 NC Primary

Addresses

Primary practice location

912 2ND St NE
Hickory, NC 28601-3851

Mailing address

912 2ND St NE
Hickory, NC 28601-3851
Phone (828) 267-1916

Other identifiers 4

IdentifierTypeStateIssuer
2030547002OtherNCCIGNA
26-42566OtherNCUHC
0804EOtherNCBC BS
890804EMedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091020000200 NC Part B Supplier - Clinic/Group Practice 5890840334 Receives reassigned benefits from 1 practitioner
Practice locations: Hickory, NC

National Provider Directory

National Provider Directory

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": "1246320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1174751960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 2ND ST NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013851",
            "telephone_number": "828-267-1916",
            "fax_number": "828-267-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 2ND ST NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013851",
            "telephone_number": "828-267-1916",
            "fax_number": "828-267-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIFOUR PODIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-30",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "GROGAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "HENRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-267-1916",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "430",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2030547002",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "26-42566",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "0804E",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890804E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.