NPIMap

Organization Active NPI

Lake Region Family Foot & Ankle Center

  • Foot & Ankle Surgery Podiatrist
  • Windham, ME
National Provider Identifier
1255339446
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD221 Issued in ME
Legal business name
LAKE REGION FAMILY FOOT & ANKLE CENTER
Practice address
211 Tandberg TRL
Windham, ME 04062-5100
Phone
(207) 893-1989
Fax
(207) 893-0190
NPI assigned
Jul 12, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Authorized official

Name
Dr. Robbin W Frost, D.P.M.NPI 1902937436
Title
President
Phone
(207) 893-1989

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 & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X POD221 ME Primary

Addresses

Primary practice location

211 Tandberg TRL
Windham, ME 04062-5100

Mailing address

211 Tandberg TRL
Windham, ME 04062-5100
Phone (207) 893-1989

Other identifiers 1

IdentifierTypeStateIssuer
156880000MedicaidME

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1121126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312416000000",
    "number": "1255339446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 TANDBERG TRL",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040625100",
            "telephone_number": "207-893-1989",
            "fax_number": "207-893-0190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 TANDBERG TRL",
            "city": "WINDHAM",
            "state": "ME",
            "postal_code": "040625100",
            "telephone_number": "207-893-1989",
            "fax_number": "207-893-0190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE REGION FAMILY FOOT & ANKLE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-12",
        "last_updated": "2011-08-04",
        "status": "A",
        "authorized_official_last_name": "FROST",
        "authorized_official_first_name": "ROBBIN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-893-1989",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ME",
            "license": "POD221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156880000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windham, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2011; 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.