Active NPI
Janice Therese Satajo Bautista, DPM
- Podiatrist
- Providence, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- LPR00257
- Practice address
- 825 Chalkstone Ave
Providence, RI 02908-4728 - Phone
- (401) 456-2000
- NPI assigned
- Jun 15, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | LPR00257 | RI | Primary |
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 863 | NC | |
| Foot Surgery Podiatrist | 213ES0131X | 863 | NC | |
| Primary Podiatric Medicine Podiatrist | 213EP1101X | 863 | NC |
Addresses
Primary practice location
825 Chalkstone Ave
Providence, RI 02908-4728
Mailing address
1036 Branchview Dr Ste 216
Concord, NC 28025-0113
Phone (704) 886-1918
Other practice location 1
123 Pompano Pl Ste 500
Jacksonville, NC 28546-5294
Phone (910) 939-3668
Other practice location 2
205 E Main St
Wallace, NC 28466-2721
Phone (910) 285-3362
Other practice location 3
1602 Doctors Cir
Wilmington, NC 28401-7406
Phone (910) 791-1300
Other practice location 4
603 Pecan Ln
Whiteville, NC 28472-2949
Phone (910) 642-0473
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250605002727 | RI | Order and Referring Only - Podiatry | 1850801259 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 863 | NC | MD | Professional Counselor |
| LPR00257 | RI | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Instride Foot and Ankle Specialists, PLLC | Podiatrist | Current | Accepting new patients |
| Instride Foot and Ankle Specialists, PLLC | Podiatrist | Past | Accepting new patients |
Locations
1036 Branchview Dr
Ste 216
Concord, NC 28025
Phone (704) 886-1918
123 Pompano Pl
Ste 500
Jacksonville, NC 28546
Phone (910) 939-3668
205 E Main St
Wallace, NC 28466
Phone (910) 285-3362
603 Pecan Ln
Whiteville, NC 28472
Phone (910) 640-1400
1602 Doctors Cir
Wilmington, NC 28401
Phone (910) 343-8889
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Primary Podiatric Medicine Podiatrist
- Concord, NC
- NPI 1457601601
-
- Primary Podiatric Medicine Podiatrist
- King, NC
- NPI 1063390862
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1686787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1779321600000",
"number": "1275217507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1036 BRANCHVIEW DR STE 216",
"city": "CONCORD",
"state": "NC",
"postal_code": "280250113",
"telephone_number": "704-886-1918"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 CHALKSTONE AVE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029084728",
"telephone_number": "401-456-2000"
}
],
"practiceLocations": [
{
"address_1": "123 Pompano Pl Ste 500",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "NC",
"postal_code": "285465294",
"country_code": "US",
"telephone_number": "910-939-3668",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "205 E Main St",
"address_purpose": "LOCATION",
"city": "Wallace",
"state": "NC",
"postal_code": "284662721",
"country_code": "US",
"telephone_number": "910-285-3362",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1602 Doctors Cir",
"address_purpose": "LOCATION",
"city": "Wilmington",
"state": "NC",
"postal_code": "284017406",
"country_code": "US",
"telephone_number": "910-791-1300",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "603 Pecan Ln",
"address_purpose": "LOCATION",
"city": "Whiteville",
"state": "NC",
"postal_code": "284722949",
"country_code": "US",
"telephone_number": "910-642-0473",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BAUTISTA",
"first_name": "JANICE THERESE",
"middle_name": "SATAJO",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-15",
"last_updated": "2026-05-21",
"certification_date": "2026-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "RI",
"license": "LPR00257",
"primary": true
},
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "NC",
"license": "863",
"primary": false
},
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "NC",
"license": "863",
"primary": false
},
{
"code": "213EP1101X",
"taxonomy_group": "",
"desc": "Podiatrist, Primary Podiatric Medicine",
"state": "NC",
"license": "863",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.