Organization Active NPI

Goldenfeet Inc

  • Foot Surgery Podiatrist
  • Palm Coast, FL
National Provider Identifier
1205256617
Registry record updated Jul 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
Legal business name
GOLDENFEET INC
Practice address
4877 Palm Coast Pkwy NW Unit 4
Palm Coast, FL 32137-3677
Phone
(386) 490-9990
Fax
(386) 263-8768
NPI assigned
Apr 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2023

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

Authorized official

Name
Joe Li, DPMNPI 1649582628
Title
President
Phone
(386) 490-9990

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
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X Primary

Addresses

Primary practice location

4877 Palm Coast Pkwy NW Unit 4
Palm Coast, FL 32137-3677

Mailing address

4877 Palm Coast Pkwy NW Unit 4
Palm Coast, FL 32137-3677
Phone (386) 490-9990

Other identifiers 1

IdentifierTypeStateIssuer
012374100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140603002629 FL Part B Supplier - Clinic/Group Practice 6305069774 Receives reassigned benefits from 1 practitioner
Practice locations: Palm Coast, FL
O20150505002938 FL DME Supplier - Physician - Podiatry 6305069774 Practice locations: Palm Coast, FL

National Provider Directory

National Provider Directory

Locations

4877 Palm Coast Pkwy NW
Unit 4
Palm Coast, FL 32137
Phone (386) 490-9990

4867 Palm Coast Pkwy NW
Unit 1
Palm Coast, FL 32137
Phone (904) 490-9990

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": "1398297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689552000000",
    "number": "1205256617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4877 PALM COAST PKWY NW UNIT 4",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373677",
            "telephone_number": "386-490-9990",
            "fax_number": "386-263-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4877 PALM COAST PKWY NW UNIT 4",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373677",
            "telephone_number": "386-490-9990",
            "fax_number": "386-263-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDENFEET INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-24",
        "last_updated": "2023-07-17",
        "certification_date": "2023-07-17",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "JOE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-490-9990",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "012374100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2023; 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.