Georgia Podiatry, Inc

Primary specialty

PodiatristTaxonomy code 213E00000X

License

000937 Issued in GA

Legal business name

GEORGIA PODIATRY, INC

Practice address

5205 Stilesboro Rd NW Ste 205
Kennesaw, GA 30152-7765

Phone

(678) 310-0540

Fax

(678) 310-0538

NPI assigned

May 26, 2011

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary J Stephens

Title

Practice Manager

Phone

(678) 310-0540

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

Locations

Practitioners 5

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.

• Evan M Brody, DPM

  • Podiatrist
  • Kennesaw, GA
  • NPI 1679548168
  Medicare reassignment Care Compare group NPD
• Erin Jeannine Cupolo, D.P.M.

  • Podiatrist
  • Kennesaw, GA
  • NPI 1134360175
  Medicare reassignment Care Compare group NPD
• Harshil Patel

  • Foot & Ankle Surgery Podiatrist
  • Acworth, GA
  • NPI 1982054151
  Medicare reassignment Care Compare group NPD
• Alvin Cowans, DPM

  • Foot & Ankle Surgery Podiatrist
  • Powder Springs, GA
  • NPI 1164812202
  NPD
• Ashish Kapila, DPM

  • Podiatrist
  • Smyrna, GA
  • NPI 1093081903
  NPD

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1215220090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5205 STILESBORO RD.",
            "address_2": "SUITE 205",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527760",
            "telephone_number": "678-310-0540",
            "fax_number": "678-310-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5205 STILESBORO RD NW STE 205",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527765",
            "telephone_number": "678-310-0540",
            "fax_number": "678-310-0538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 E Freeway Dr SE",
            "address_purpose": "LOCATION",
            "city": "Conyers",
            "state": "GA",
            "postal_code": "300945965",
            "country_code": "US",
            "telephone_number": "770-929-3338",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1599 Mulkey Rd",
            "address_purpose": "LOCATION",
            "city": "Austell",
            "state": "GA",
            "postal_code": "301061111",
            "country_code": "US",
            "telephone_number": "678-505-8064",
            "fax_number": "678-909-5967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GEORGIA PODIATRY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2022-07-21",
        "certification_date": "2021-06-09",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "678-310-0540"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "000937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "520666344",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DR8420",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1215220090",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "1679548168",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.