Organization Active NPI

Foot and Ankle Surgical Assoc

  • Podiatrist
  • Wells, ME
National Provider Identifier
1205816766
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD1039 Issued in ME
Legal business name
FOOT AND ANKLE SURGICAL ASSOC
Practice address
952 Post Road
Foot and Ankle Surgical Assoc
Wells, ME 04090
Phone
(207) 646-9996
Fax
(207) 646-9949
NPI assigned
Jan 20, 2006
Last updated
Jul 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Authorized official

Name
Steven Bragg
Title
Billing Manager
Phone
(207) 854-1544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X POD1039 ME Primary

Addresses

Primary practice location

952 Post Road
Foot and Ankle Surgical Assoc
Wells, ME 04090

Mailing address

PO Box 810
Foot and Ankle Surgical Assoc
Westbrook, ME 04098-0810
Phone (207) 854-1544

Other identifiers 5

IdentifierTypeStateIssuer
431952200MedicaidME
022848OtherMEANTHEM MAINE
1659479541OtherMEIND NPI #
1205816766OtherMEGROUP NPI #
MM9150OtherMEMEDICARE IND PIN

National Provider Directory

National Provider Directory

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": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1205816766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 810",
            "address_2": "FOOT AND ANKLE SURGICAL ASSOC",
            "city": "WESTBROOK",
            "state": "ME",
            "postal_code": "040980810",
            "telephone_number": "207-854-1544",
            "fax_number": "207-854-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "952 POST ROAD",
            "address_2": "FOOT AND ANKLE SURGICAL ASSOC",
            "city": "WELLS",
            "state": "ME",
            "postal_code": "04090",
            "telephone_number": "207-646-9996",
            "fax_number": "207-646-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE SURGICAL ASSOC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "BRAGG",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "207-854-1544"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "ME",
            "license": "POD1039",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431952200",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM MAINE",
            "identifier": "022848",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND NPI #",
            "identifier": "1659479541",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI #",
            "identifier": "1205816766",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE IND PIN",
            "identifier": "MM9150",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wells, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.