NPIMap

Organization Active NPI

Atlantic Foot and Ankle Specists

  • Foot & Ankle Surgery Podiatrist
  • Pooler, GA
National Provider Identifier
1295873636
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
ATLANTIC FOOT AND ANKLE SPECISTS
Practice address
114 Canal St Ste 703
Pooler, GA 31322-4291
Phone
(912) 988-3323
Fax
(912) 988-3612
NPI assigned
Feb 1, 2007
Last updated
Feb 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Authorized official

Name
Dr. Melissa F Robitaille, DPMNPI 1386655991
Title
Owner
Phone
(912) 988-3323

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

114 Canal St Ste 703
Pooler, GA 31322-4291

Mailing address

114 Canal St Ste 703
Pooler, GA 31322-4291
Phone (912) 988-3323

Other names 1

  • Atlantic Foot & Ankle Specialists Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040426001073 GA Part B Supplier - Clinic/Group Practice 6406843226 Receives reassigned benefits from 2 practitioners
Practice locations: Pooler, GA
O20100930048732 GA DME Supplier - Physician - Podiatry 6406843226 Practice locations: Pooler, GA

National Provider Directory

National Provider Directory
Tax ID family
Atlantic Foot and Ankle Specialists2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

114 Canal St
Ste 703
Pooler, GA 31322
Phone (912) 988-3323

Practitioners & affiliated clinicians

Practitioners 2

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": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646006400000",
    "number": "1295873636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 CANAL ST STE 703",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224291",
            "telephone_number": "912-988-3323",
            "fax_number": "912-988-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 CANAL ST STE 703",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313224291",
            "telephone_number": "912-988-3323",
            "fax_number": "912-988-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC FOOT AND ANKLE SPECISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "ROBITAILLE",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "912-988-3323",
        "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
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Atlantic Foot & Ankle Specialists",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pooler, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.