NPIMap

Organization Active NPI

Premier Podiatry of Virginia LLC

  • Podiatrist
  • Owings Mills, MD
National Provider Identifier
1356430078
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
PREMIER PODIATRY OF VIRGINIA LLC
Practice address
10989 Red Run Blvd
Suite 208
Owings Mills, MD 21117-3283
Phone
(410) 654-8602
Fax
(410) 654-8709
NPI assigned
Oct 12, 2006
Last updated
Oct 23, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Authorized official

Name
Dr. Franklin R. Polun, DPMNPI 1881697886
Title
President
Phone
(410) 654-8602

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
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

10989 Red Run Blvd
Suite 208
Owings Mills, MD 21117-3283

Mailing address

10989 Red Run Blvd
Suite 208
Owings Mills, MD 21117-3283
Phone (410) 654-8602

National Provider Directory

National Provider Directory

Locations

10989 Red Run Blvd
Owings Mills, MD 21117
Phone 4106548602101

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193097600000",
    "number": "1356430078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10989 RED RUN BLVD",
            "address_2": "SUITE 208",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173283",
            "telephone_number": "410-654-8602",
            "fax_number": "410-654-8709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10989 RED RUN BLVD",
            "address_2": "SUITE 208",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173283",
            "telephone_number": "410-654-8602",
            "fax_number": "410-654-8709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PODIATRY OF VIRGINIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-10-23",
        "status": "A",
        "authorized_official_last_name": "POLUN",
        "authorized_official_first_name": "FRANKLIN",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-654-8602",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.