NPIMap

Organization Active NPI

Southwest Family Footcare Specialist, LLC

  • Foot & Ankle Surgery Podiatrist
  • South Haven, MI
National Provider Identifier
1326236514
Registry record updated Dec 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
5901001629 Issued in MI
Legal business name
SOUTHWEST FAMILY FOOTCARE SPECIALIST, LLC
Practice address
10570 Blue Star M Hwy
South Haven, MI 49090-8923
Phone
(269) 639-1115
Fax
(269) 639-2525
NPI assigned
Oct 12, 2007
Last updated
Dec 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2007

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

Authorized official

Name
Dr. Regina Lynne Spears, D.P.M.NPI 1568464501
Title
President
Phone
(269) 639-1115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 5901001629 MI Primary

Addresses

Primary practice location

10570 Blue Star M Hwy
South Haven, MI 49090-8923

Mailing address

PO Box 2078
Portage, MI 49081-2078
Phone (269) 639-1115

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196726400000",
    "number": "1326236514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2078",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490812078",
            "telephone_number": "269-639-1115",
            "fax_number": "269-639-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10570 BLUE STAR M HWY",
            "city": "SOUTH HAVEN",
            "state": "MI",
            "postal_code": "490908923",
            "telephone_number": "269-639-1115",
            "fax_number": "269-639-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST FAMILY FOOTCARE SPECIALIST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2007-12-04",
        "status": "A",
        "authorized_official_last_name": "SPEARS",
        "authorized_official_first_name": "REGINA",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-639-1115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5901001629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.