Naomi Phayne, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

01395 Issued in MD

Practice address

650 Joel Drive
Podiatry Clinic
Fort Campbell, KY 42223

Phone

(270) 798-8638

NPI assigned

Oct 25, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694304000000",
    "number": "1326038803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DRIVE",
            "address_2": "PODIATRY CLINIC",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "702-798-8638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DRIVE",
            "address_2": "PODIATRY CLINIC",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "42223",
            "telephone_number": "270-798-8638"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W Hospital Rd",
            "address_2": "Podiatry Clinic",
            "address_purpose": "LOCATION",
            "city": "Fort Gordon",
            "state": "GA",
            "postal_code": "309055741",
            "country_code": "US",
            "telephone_number": "706-787-0694",
            "fax_number": "706-787-2760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAYNE",
        "first_name": "NAOMI",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-25",
        "last_updated": "2023-09-10",
        "certification_date": "2023-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "01395",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": "01395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberley Ann Peterson, MSW, LICSW
• Rachel Elaine Peterson, LCSW
• Michael Carroll Petitt, RPH, PHARM.D.
• Shell Marie Pfeiffer, LCSW
• Anh Ngoc Pham, PA
• Kasey Marie Phillips
• Kimberley Jo Phillips, MD, MPH
• Irene Park Pickens, LCSW
• Rachel A Pierce, LMHC, LPC
• Lisa Michelle Pierson, M.D.

• Foot & Ankle Surgery Podiatrist in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Foot & Ankle Surgery Podiatrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2023; 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.

Verify at the official NPI Registry.