Organization Active NPI

Womick Podiatry Clinic P C

  • Podiatrist
  • Newport News, VA
National Provider Identifier
1346372497
Registry record updated Mar 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0103001012 Issued in VA
Legal business name
WOMICK PODIATRY CLINIC P C
Practice address
704 Thimble Shoals Blvd
Ste 300B
Newport News, VA 23606-4554
Phone
(757) 595-7634
Fax
(757) 595-7635
NPI assigned
Mar 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2013

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

Authorized official

Name
Dr. Debra A. Womick Lee, D.P.M.
Title
Doctor
Phone
(757) 595-7634

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 0103001012 VA Primary

Addresses

Primary practice location

704 Thimble Shoals Blvd
Ste 300B
Newport News, VA 23606-4554

Mailing address

704 Thimble Shoals Blvd
Ste 300B
Newport News, VA 23606-4554
Phone (757) 595-7634

Other identifiers 1

IdentifierTypeStateIssuer
9303812MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200409000039 VA Part B Supplier - Clinic/Group Practice 1254452451 Receives reassigned benefits from 1 practitioner
Practice locations: Gloucester, VA; Newport News, VA

National Provider Directory

National Provider Directory

Locations

704 Thimble Shoals Blvd
Ste 300B
Newport News, VA 23606
Phone (757) 595-7634

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363910400000",
    "number": "1346372497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 THIMBLE SHOALS BLVD",
            "address_2": "STE 300B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064554",
            "telephone_number": "757-595-7634",
            "fax_number": "757-595-7635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 THIMBLE SHOALS BLVD",
            "address_2": "STE 300B",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064554",
            "telephone_number": "757-595-7634",
            "fax_number": "757-595-7635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMICK PODIATRY CLINIC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2013-03-22",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "A. WOMICK",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "757-595-7634",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103001012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9303812",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 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.