Organization Active NPI

Southern Maryland Foot and Ankle LLC

Doing business as Southern Maryland Foot and Ankle

  • Foot & Ankle Surgery Podiatrist
  • Waldorf, MD
National Provider Identifier
1285809715
Registry record updated Nov 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
SOUTHERN MARYLAND FOOT AND ANKLE LLC
Doing business as
Southern Maryland Foot and Ankle
Practice address
12070 Old Line Ctr Ste 110
Waldorf, MD 20602-2503
Phone
(301) 843-9581
NPI assigned
Apr 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2025

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

Authorized official

Name
Dr. Justin Pointer, DPMNPI 1659636082
Title
Owner
Phone
(301) 843-9581

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 Primary

Addresses

Primary practice location

12070 Old Line Ctr Ste 110
Waldorf, MD 20602-2503

Mailing address

12070 Old Line Ctr Ste 110
Waldorf, MD 20602-2503
Phone (301) 843-9581

Other names 1

  • Southern Maryland Foot and Ankle Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20061219000430 DC Part B Supplier - Clinic/Group Practice 9830198928 Receives reassigned benefits from 9 practitioners
Practice locations: Clinton, MD; Waldorf, MD
O20061221000160 MD Part B Supplier - Clinic/Group Practice 9830198928 Receives reassigned benefits from 8 practitioners
1 other NPI on this enrollment
Practice locations: California, MD; Waldorf, MD
O20100930041155 MD DME Supplier - Physician - Podiatry 9830198928 Practice locations: Waldorf, MD

National Provider Directory

National Provider Directory

Locations

23415 Three Notch Rd
Ste 2054
California, MD 20619
Phone (301) 690-6044

9135 Piscataway Rd
Ste 102
Clinton, MD 20735
Phone (301) 868-3899

12070 Old Line Ctr
Ste 110
Waldorf, MD 20602
Phone (301) 638-0021

Practitioners & affiliated clinicians

Practitioners 9

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": "1209081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763078400000",
    "number": "1285809715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR STE 110",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022503",
            "telephone_number": "301-843-9581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR STE 110",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022503",
            "telephone_number": "301-843-9581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MARYLAND FOOT AND ANKLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-25",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A",
        "authorized_official_last_name": "POINTER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-843-9581",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "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": "Southern Maryland Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.