Organization Active NPI

Advanced Innovations Podiatry LLC

  • Foot & Ankle Surgery Podiatrist
  • Vero Beach, FL
National Provider Identifier
1194664953
Registry record updated Mar 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
ADVANCED INNOVATIONS PODIATRY LLC
Practice address
1700 Waterford Dr
Vero Beach, FL 32966-8043
Phone
(772) 275-4923
NPI assigned
Mar 26, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2026

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

Authorized official

Name
Forton Wimbush
Title
Authorized Signer
Phone
(510) 914-1223

Specialties & licenses 1

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

Addresses

Primary practice location

1700 Waterford Dr
Vero Beach, FL 32966-8043

Mailing address

7901 4TH St N Ste 300
St Petersburg, FL 33702-4399

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": "1774483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774483200000",
    "number": "1194664953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 4TH ST N STE 300",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337024399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 WATERFORD DR",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329668043",
            "telephone_number": "772-275-4923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED INNOVATIONS PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-26",
        "last_updated": "2026-03-26",
        "certification_date": "2026-03-26",
        "status": "A",
        "authorized_official_last_name": "WIMBUSH",
        "authorized_official_first_name": "FORTON",
        "authorized_official_title_or_position": "AUTHORIZED SIGNER",
        "authorized_official_telephone_number": "510-914-1223"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vero Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2026; 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.