NPIMap

Organization Active NPI

Speedway Podiatry Inc.

  • Podiatrist
  • Speedway, IN
National Provider Identifier
1245431865
Registry record updated Jul 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
52000059A Issued in IN
Legal business name
SPEEDWAY PODIATRY INC.
Practice address
5388 W 10TH St
Speedway, IN 46224-6818
Phone
(317) 241-2107
Fax
(317) 240-1198
NPI assigned
May 30, 2007
Last updated
Jul 21, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2010

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

Authorized official

Name
Dr. Lynn A. Gibney, D.P.M.NPI 1013955491
Title
President
Phone
(317) 241-2107

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 52000059A IN Primary

Addresses

Primary practice location

5388 W 10TH St
Speedway, IN 46224-6818

Mailing address

5388 W 10TH St
Speedway, IN 46224-6818
Phone (317) 241-2107

National Provider Directory

National Provider Directory

Locations

5388 W 10th St
Speedway, IN 46224
Phone (317) 241-2107

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": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1245431865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5388 W 10TH ST",
            "city": "SPEEDWAY",
            "state": "IN",
            "postal_code": "462246818",
            "telephone_number": "317-241-2107",
            "fax_number": "317-240-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5388 W 10TH ST",
            "city": "SPEEDWAY",
            "state": "IN",
            "postal_code": "462246818",
            "telephone_number": "317-241-2107",
            "fax_number": "317-240-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEEDWAY PODIATRY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "GIBNEY",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-241-2107",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "52000059A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Speedway, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.