St Vincents Multispecialty Group Inc

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

ST VINCENTS MULTISPECIALTY GROUP INC

Doing business as

Family Foot & Ankle Specialists

Practice address

2409 Main St
Bridgeport, CT 06606-5324

Phone

(203) 334-6955

Fax

(203) 334-2851

NPI assigned

Jul 22, 2019

Last updated

Jul 22, 2019By the provider in NPPES

Organization subpart

Yes

Parent organization

ST VINCENTS MULTISPECIALTY GROUP INCAs reported in NPPES

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

Authorized official

Name

Llatoya Gayle

Title

Credentialing Specialist

Phone

(475) 210-5346

Specialties & licenses 2

Addresses

Other names 1

• Family Foot & Ankle Specialists Doing business as

Part of

St Vincents Multispecialty Group Inc

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563753600000",
    "number": "1205489077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065363",
            "telephone_number": "475-210-5346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066065324",
            "telephone_number": "203-334-6955",
            "fax_number": "203-334-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST VINCENTS MULTISPECIALTY GROUP INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST VINCENTS MULTISPECIALTY GROUP INC",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A",
        "authorized_official_last_name": "GAYLE",
        "authorized_official_first_name": "LLATOYA",
        "authorized_official_title_or_position": "CREDENTIALING  SPECIALIST",
        "authorized_official_telephone_number": "475-210-5346"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Foot & Ankle Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kevin J Sprague II, M.D.
• Rafael P Squitieri, MD
• St Vincent's Medical Center
• St Vincent's Medical Center (HOPE Charitable Pharmacy of Greater Bridgeport)
• St Vincents Medical Center (St Vincent's Outpatient Pharmacy)
• Britnia St. Pierre, RN
• St. Vincent's Behavioral Health Services
• St. Vincent's Health Partners, Inc.
• St. Vincents Medical Center
• St. Vincents Medical Center

• Podiatrist in Bridgeport, CT
• Providers in Bridgeport, CT by specialty
• Podiatrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.