Diabetic Foot and Wound Care Center PLLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

5901001528 Issued in MI

Legal business name

DIABETIC FOOT AND WOUND CARE CENTER PLLC

Practice address

1281 E Sherman Blvd
Muskegon, MI 49444-1846

Phone

(231) 733-1511

Fax

(231) 733-7980

NPI assigned

Apr 19, 2010

Organization subpart

No

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

Authorized official

Name

Susan E HolibaughNPI 1235107632

Title

President

Phone

(231) 733-1511

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

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

• Susan E Holibaugh, DPM

  • Foot Surgery Podiatrist
  • Muskegon, MI
  • NPI 1235107632
  Medicare reassignment Care Compare group NPD Authorized official
• Megan Melissa Demara, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Norton Shores, MI
  • NPI 1649607375
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393200000000",
    "number": "1235455031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1281 E SHERMAN BLVD",
            "address_2": "PO BOX 4323",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441846",
            "telephone_number": "231-733-1511",
            "fax_number": "231-733-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1281 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441846",
            "telephone_number": "231-733-1511",
            "fax_number": "231-733-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETIC FOOT AND WOUND CARE CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-19",
        "last_updated": "2014-02-24",
        "status": "A",
        "authorized_official_last_name": "HOLIBAUGH",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-733-1511"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maureen Nicole Dewitt, M.D.
• Amanda Dexter
• Bonnie Lou Deyoung, RNCNP
• Roger L Deyoung, D.P.M.
• Bazamdeep Singh Dhillon
• Diabetic Foot PLLC
• Diagnostic Laboratory Services, PLC
• Stella E Dial, LICENSED PSYCHOLOGIS
• Christina Diaz-Flores
• Miguel Diaz

• Podiatrist in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; 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.