Family Foot and Ankle Center

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

POD000753 Issued in GA

Legal business name

FAMILY FOOT AND ANKLE CENTER

Practice address

841 Mulberry St
Macon, GA 31201-6756

Phone

(478) 741-1192

Fax

(478) 741-0029

NPI assigned

Jan 11, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Roger P Theodore, D.P.M.NPI 1154398402

Title

Podiatrist

Phone

(478) 741-1192

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Tax ID family

Family Foot and Ankle Center2 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.

• Family Foot and Ankle Ctr

  • Podiatrist
  • Macon, GA
  • NPI 1124152459
  NPD tax ID

Locations

Practitioners 1

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

• Roger Peter Theodore, DPM

  • Podiatrist
  • Macon, GA
  • NPI 1154398402
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359936000000",
    "number": "1306183280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "841 MULBERRY ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016756",
            "telephone_number": "478-741-1192",
            "fax_number": "478-741-0029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "841 MULBERRY ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312016756",
            "telephone_number": "478-741-1192",
            "fax_number": "478-741-0029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FOOT AND ANKLE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-11",
        "last_updated": "2013-02-04",
        "status": "A",
        "authorized_official_last_name": "THEODORE",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "478-741-1192",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "GA",
            "license": "POD000753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Family Behavioral Care of Central Ga, PC
• Family Care Solutions Inc
• Family Counseling Center
• Family Counseling Center of Central Ga., Inc.
• Family Counseling Center of Central Ga., Inc.
• Family Foot and Ankle Ctr
• Family Health Care of Macon, P.C.
• Family Hospice Macon, LLC
• Family Medicine at Northside LLC
• Family of Life Healthcare, LLC

• Foot Surgery Podiatrist in Macon, GA
• Providers in Macon, GA by specialty
• Foot Surgery Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; 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.