NPIMap

Organization Active NPI

Coastal Foot Clinic, a P.C.

  • Podiatrist
  • New Roads, LA
National Provider Identifier
1316225568
Registry record updated Jul 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PD165R Issued in LA
Legal business name
COASTAL FOOT CLINIC, A P.C.
Practice address
230 Roberts Dr
Suite G
New Roads, LA 70760-2661
Phone
(225) 638-6640
Fax
(225) 618-0863
NPI assigned
Jul 21, 2011
Last updated
Jul 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2011

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

Authorized official

Name
Dr. Richard G Palecki, D.P.M.NPI 1639268196
Title
President
Phone
(225) 718-5314

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X PD165R LA Primary

Addresses

Primary practice location

230 Roberts Dr
Suite G
New Roads, LA 70760-2661

Mailing address

PO Box 575
Livonia, LA 70755-0575
Phone (225) 234-0048

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1311206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311206400000",
    "number": "1316225568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 575",
            "city": "LIVONIA",
            "state": "LA",
            "postal_code": "707550575",
            "telephone_number": "225-234-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 ROBERTS DR",
            "address_2": "SUITE G",
            "city": "NEW ROADS",
            "state": "LA",
            "postal_code": "707602661",
            "telephone_number": "225-638-6640",
            "fax_number": "225-618-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL FOOT CLINIC, A P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-21",
        "last_updated": "2011-07-21",
        "status": "A",
        "authorized_official_last_name": "PALECKI",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "225-718-5314",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "LA",
            "license": "PD165R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Roads, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.