NPIMap

Organization Active NPI

Foot and Ankle Center LLC

  • Foot Surgery Podiatrist
  • Marrero, LA
National Provider Identifier
1225158397
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
PD228R Issued in LA
Legal business name
FOOT AND ANKLE CENTER LLC
Practice address
1111 Medical Center Blvd
Suite N507
Marrero, LA 70072-3151
Phone
(504) 349-6633
Fax
(504) 349-6631
NPI assigned
Mar 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Authorized official

Name
Dr. Denise Lea Elliott, DMPNPI 1730152760
Title
President
Phone
(504) 349-6633

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X PD228R LA Primary

Addresses

Primary practice location

1111 Medical Center Blvd
Suite N507
Marrero, LA 70072-3151

Mailing address

1111 Medical Center Blvd
#N-507
Marrero, LA 70072-3151
Phone (504) 349-6633

Other identifiers 3

IdentifierTypeStateIssuer
0007796175OtherLAAETNA
106425OtherLACOVENTRY
1443786MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100914000510 LA Part B Supplier - Clinic/Group Practice 9335264381 Receives reassigned benefits from 2 practitioners
Practice locations: Marrero, LA
O20100930044504 LA DME Supplier - Physician - Podiatry 9335264381 Practice locations: Marrero, LA

National Provider Directory

National Provider Directory

Locations

1111 Medical Center Blvd
Ste 507
Marrero, LA 70072
Phone (504) 349-6633

Practitioners & affiliated clinicians

Practitioners 3

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": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209081600000",
    "number": "1225158397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "#N-507",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6633",
            "fax_number": "504-349-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 MEDICAL CENTER BLVD",
            "address_2": "SUITE N507",
            "city": "MARRERO",
            "state": "LA",
            "postal_code": "700723151",
            "telephone_number": "504-349-6633",
            "fax_number": "504-349-6631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2008-04-25",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "504-349-6633",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMP"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "LA",
            "license": "PD228R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0007796175",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "106425",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1443786",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marrero, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2008; 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.