John J Degovann DPM PC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

SC001467L Issued in PA

Legal business name

JOHN J DEGOVANN DPM PC

Doing business as

Manayunk Foot and Ankle

Practice address

5735 Ridge Ave Ste 203
Philadelphia, PA 19128-1747

Phone

(215) 487-0475

Fax

(215) 487-0171

NPI assigned

May 2, 2012

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James D Sandy, DPMNPI 1700050101

Title

President

Phone

(215) 487-0475

Specialties & licenses 1

Addresses

Other names 1

• Manayunk Foot and Ankle Doing business as

Locations

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.

• James Dennis Sandy Jr., DPM

  • Foot & Ankle Surgery Podiatrist
  • Philadelphia, PA
  • NPI 1700050101
  NPD Authorized official

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

{
    "created_epoch": "1335916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1194083790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5735 RIDGE AVE STE 203",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281747",
            "telephone_number": "215-487-0475",
            "fax_number": "215-487-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5735 RIDGE AVE STE 203",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191281747",
            "telephone_number": "215-487-0475",
            "fax_number": "215-487-0171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Walnut Ln",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191281713",
            "country_code": "US",
            "telephone_number": "215-487-1510",
            "fax_number": "215-487-0540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JOHN J DEGOVANN DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SANDY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "215-487-0475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "PA",
            "license": "SC001467L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manayunk Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Podiatric Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Podiatric Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.