NPIMap

Organization Active NPI

Foot & Ankle Wellness Center

  • Podiatrist
  • Delaware, OH
National Provider Identifier
1205025491
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36002064G Issued in OH
Legal business name
FOOT & ANKLE WELLNESS CENTER
Practice address
1871 W William St
Delaware, OH 43015-2255
Phone
(740) 363-4373
Fax
(740) 363-9560
NPI assigned
Oct 24, 2007
Last updated
Apr 21, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Authorized official

Name
Martha Anderson, DPMNPI 1700056306
Title
Owner
Phone
(937) 509-0090

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 36002064G OH Primary

Addresses

Primary practice location

1871 W William St
Delaware, OH 43015-2255

Mailing address

1871 W William St
Delaware, OH 43015-2255
Phone (740) 363-4373

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dranderson@faawc.medentdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050919001096 OH Part B Supplier - Clinic/Group Practice 5395779458 Receives reassigned benefits from 8 practitioners
Practice locations: Delaware, OH
O20100930001887 OH DME Supplier - Physician - Podiatry 5395779458 Practice locations: Delaware, OH

National Provider Directory

National Provider Directory

Locations

1871 W William St
Delaware, OH 43015
Phone (740) 363-4373

Interoperability endpoints

  • Direct secure messaging: dranderson@faawc.medentdirect.com

Practitioners & affiliated clinicians

Practitioners 8

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": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618963200000",
    "number": "1205025491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1871 W WILLIAM ST",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430152255",
            "telephone_number": "740-363-4373",
            "fax_number": "740-363-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1871 W WILLIAM ST",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430152255",
            "telephone_number": "740-363-4373",
            "fax_number": "740-363-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-509-0090",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36002064G",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dranderson@faawc.medentdirect.com",
            "affiliation": "N",
            "address_1": "1871 W William St",
            "city": "Delaware",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430152255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Delaware, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.