NPIMap

Organization Active NPI

Smoky Mountain Foot Clinic PA

  • Podiatrist
  • Asheville, NC
National Provider Identifier
1205911906
Registry record updated Nov 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
469 Issued in NC
Legal business name
SMOKY MOUNTAIN FOOT CLINIC PA
Practice address
573 Merrimon Ave
Asheville, NC 28804-3490
Phone
(828) 254-7716
NPI assigned
Oct 25, 2006
Last updated
Nov 9, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2011

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

Authorized official

Name
William D Banks, DPMNPI 1417943887
Title
Ceo
Phone
(828) 452-4343

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 346 NC
Podiatrist 213E00000X B01 NC
Podiatrist 213E00000X 380 NC
Podiatrist 213E00000X 469 NC Primary

Addresses

Primary practice location

573 Merrimon Ave
Asheville, NC 28804-3490

Mailing address

PO Box 278
Clyde, NC 28721-0278
Phone (828) 452-4343

Other identifiers 9

IdentifierTypeStateIssuer
0800AOtherNCBCBS
5911409MedicaidNC
890800AMedicaidNC
0807KOtherNCBCBS
0808POtherBCBS
890808PMedicaidNC
89086BMedicaidNC
0806BOtherNCBCBS
890801KMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20070124000025 NC Part B Supplier - Clinic/Group Practice 5991706699 Receives reassigned benefits from 7 practitioners
4 other NPIs on this enrollment
Practice locations: Waynesville, NC; Sylva, NC; Franklin, NC; Asheville, NC; Murphy, NC
O20101019000149 NC DME Supplier - Physician - Podiatry 5991706699 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Waynesville, NC
O20101026001549 NC DME Supplier - Physician - Podiatry 5991706699 Practice locations: Asheville, NC

Other NPIs with the same Medicare PAC ID 2

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

Locations

49 McDowell St
Asheville, NC 28801
Phone (828) 252-0331

289 Access Rd
Waynesville, NC 28785
Phone (828) 452-4343

Practitioners & affiliated clinicians

Practitioners 9

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": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320796800000",
    "number": "1205911906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 278",
            "city": "CLYDE",
            "state": "NC",
            "postal_code": "287210278",
            "telephone_number": "828-452-4343",
            "fax_number": "828-452-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "573 MERRIMON AVE",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288043490",
            "telephone_number": "828-254-7716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMOKY MOUNTAIN FOOT CLINIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2011-11-09",
        "status": "A",
        "authorized_official_last_name": "BANKS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "828-452-4343",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "346",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "B01",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "380",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "469",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0800A",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5911409",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890800A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0807K",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0808P",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890808P",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89086B",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0806B",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890801K",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.