NPIMap

Organization Active NPI

Wellness Podiatry Corp

  • Podiatrist
  • Lincoln, CA
National Provider Identifier
1205524774
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
WELLNESS PODIATRY CORP
Doing business as
Lincoln Hills Podiatry
Wellness Podiatry
Practice address
685 Twelve Bridges Dr Ste F
Lincoln, CA 95648-8689
Phone
(916) 408-5580
NPI assigned
Apr 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Authorized official

Name
Dayna Le
Title
Am
Phone
(916) 333-9557

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X Primary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X

Addresses

Primary practice location

685 Twelve Bridges Dr Ste F
Lincoln, CA 95648-8689

Mailing address

685 Twelve Bridges Dr Ste F
Lincoln, CA 95648-8689
Phone (916) 786-3434

Other practice location 1

1650 Lead Hill Blvd Ste 100
Roseville, CA 95661-3072
Phone (916) 786-3434

Other names 2

  • Lincoln Hills Podiatry Doing business as
  • Wellness Podiatry Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230726004024 CA Part B Supplier - Clinic/Group Practice 4688035439 Receives reassigned benefits from 3 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Auburn, CA; Lincoln, CA; Roseville, CA; Sacramento, CA
O20240216001685 CA DME Supplier - Physician - Podiatry 4688035439 Practice locations: Lincoln, CA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 4

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Wellness Podiatry Corp5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

685 Twelve Bridges Dr
Ste F
Lincoln, CA 95648
Phone (916) 408-5580

305 South Dr
Ste 6
Mountain View, CA 94040
Phone (559) 201-3228

305 South Dr
Mountain View, CA 94040

5025 J St
Ste 316
Sacramento, CA 95819
Phone (916) 732-2277

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1682294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1205524774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 TWELVE BRIDGES DR STE F",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956488689",
            "telephone_number": "916-786-3434",
            "fax_number": "916-786-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 TWELVE BRIDGES DR STE F",
            "city": "LINCOLN",
            "state": "CA",
            "postal_code": "956488689",
            "telephone_number": "916-408-5580"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1650 Lead Hill Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "956613072",
            "country_code": "US",
            "telephone_number": "916-786-3434",
            "fax_number": "916-786-6770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WELLNESS PODIATRY CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "DAYNA",
        "authorized_official_title_or_position": "AM",
        "authorized_official_telephone_number": "916-333-9557"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lincoln Hills Podiatry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wellness Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.