Commonwealth Foot & Ankle Specialists LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

0103301225 Issued in VA

Legal business name

COMMONWEALTH FOOT & ANKLE SPECIALISTS LLC

Practice address

2552 Aldridge Ave
South Chesterfield, VA 23834-5306

Phone

(804) 365-5898

NPI assigned

Jul 24, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Justin A Phillingane, DPM

Title

Foot & Ankle Specialist

Phone

(804) 365-5898

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Commonwealth Foot & Ankle Specialists Doing business as

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532390400000",
    "number": "1184101065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4704 BARREL POINT RD",
            "city": "PRINCE GEORGE",
            "state": "VA",
            "postal_code": "238752976",
            "telephone_number": "305-206-7638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2552 ALDRIDGE AVE",
            "city": "SOUTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "238345306",
            "telephone_number": "804-365-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMONWEALTH FOOT & ANKLE SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A",
        "authorized_official_last_name": "PHILLINGANE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "FOOT & ANKLE SPECIALIST",
        "authorized_official_telephone_number": "804-365-5898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103301225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA BOARD OF MEDICINE",
            "identifier": "0103301225",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Commonwealth Foot & Ankle Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in South Chesterfield, VA
• Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.