NPIMap

Organization Active NPI

Anthony G Polito DPM Inc

  • Podiatrist
  • Westlake, OH
National Provider Identifier
1205024429
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36002626 Issued in OH
Legal business name
ANTHONY G POLITO DPM INC
Practice address
29099 Health Campus Dr
BLDG 3 Ste 180
Westlake, OH 44145-5200
Phone
(440) 892-6628
NPI assigned
Oct 12, 2007
Last updated
Oct 24, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Authorized official

Name
Anthony G Polito, DPM
Title
DPM Owner
Phone
(330) 722-3668

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 36002626 OH Primary

Addresses

Primary practice location

29099 Health Campus Dr
BLDG 3 Ste 180
Westlake, OH 44145-5200

Mailing address

29099 Health Campus Dr
BLDG 3 Ste 180
Westlake, OH 44145-5200
Phone (440) 892-6628

Other identifiers 1

IdentifierTypeStateIssuer
2104725MedicaidOH

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1205024429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29099 HEALTH CAMPUS DR",
            "address_2": "BLDG 3 STE 180",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455200",
            "telephone_number": "440-892-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29099 HEALTH CAMPUS DR",
            "address_2": "BLDG 3 STE 180",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455200",
            "telephone_number": "440-892-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANTHONY G POLITO DPM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "POLITO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DPM OWNER",
        "authorized_official_telephone_number": "330-722-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36002626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2104725",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.