East Bay Podiatry, PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

EAST BAY PODIATRY, PC

Practice address

2485 High School Ave Ste 222
Concord, CA 94520-1813

Phone

(925) 685-3117

NPI assigned

Jan 23, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Colleen M Kenney, D.P.M.NPI 1184629479

Title

President

Phone

(925) 685-3117

Specialties & licenses 4

Addresses

Other names 1

• Colleen M. Kenney, D.P.M. Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Practitioners 1

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

• Colleen Marie Kenney, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Concord, CA
  • NPI 1184629479
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623369600000",
    "number": "1255961793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2485 HIGH SCHOOL AVE STE 222",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945201813",
            "telephone_number": "925-685-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2485 HIGH SCHOOL AVE STE 222",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945201813",
            "telephone_number": "925-685-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY PODIATRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-23",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A",
        "authorized_official_last_name": "KENNEY",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-685-3117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "163WW0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Wound Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Colleen M. Kenney, D.P.M.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Elena Marie Eagan, C.R.C.
• Michael C Eagan
• Arielle Bianca Early
• Lee-Anne Early, OTR
• Tyler Easley
• East Bay Retina Consultants a Medical Group, Inc
• East Bay Retina Consultants a Medical Group, Inc.
• East Bay Sports Medicine and Orthopaedic Associates a Medical Corporat
• East Bay Surgical Services Inc.
• Nicole Easton

• Foot & Ankle Surgery Podiatrist in Concord, CA
• Providers in Concord, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.