Organization Active NPI

Lawrenceville Foot and Ankle Specialists

  • Foot & Ankle Surgery Podiatrist
  • Lawrenceville, GA
National Provider Identifier
1235747031
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
LAWRENCEVILLE FOOT AND ANKLE SPECIALISTS
Practice address
600 Professional Dr Ste 130
Lawrenceville, GA 30046-7638
Phone
(770) 225-0434
NPI assigned
Jul 17, 2020
Last updated
Feb 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Authorized official

Name
Cassandra Corzealious
Title
Office Manager
Phone
(770) 255-0434

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

600 Professional Dr Ste 130
Lawrenceville, GA 30046-7638

Mailing address

600 Professional Dr Ste 130
Lawrenceville, GA 30046-7638
Phone (651) 757-7516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200916000315 GA Part B Supplier - Clinic/Group Practice 4789002205 Receives reassigned benefits from 1 practitioner
Practice locations: Lawrenceville, GA
O20201019002418 GA DME Supplier - Physician - PodiatryDME Supplier - Sports Medicine 4789002205 Practice locations: Lawrenceville, GA

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": "1594944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1235747031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 PROFESSIONAL DR STE 130",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467638",
            "telephone_number": "651-757-7516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PROFESSIONAL DR STE 130",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467638",
            "telephone_number": "770-225-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCEVILLE FOOT AND ANKLE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-17",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A",
        "authorized_official_last_name": "CORZEALIOUS",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-255-0434"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; 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.