John J Land IV PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

POD000679 Issued in GA

Legal business name

JOHN J LAND IV PC

Practice address

1107 Broadrick Dr
Dalton, GA 30720-2592

Phone

(706) 278-5558

Fax

(706) 278-6334

NPI assigned

Jun 3, 2008

Organization subpart

No

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

Authorized official

Name

Dr. John J Land IV, DPMNPI 1568548220

Title

President

Phone

(706) 278-5558

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

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

• John Joseph Land IV, DPM

  • Podiatrist
  • Dalton, GA
  • NPI 1568548220

  GA, Podiatrist

  Medicare reassignment NPD Authorized official
• Greg Lifferth, DPM

  • Foot & Ankle Surgery Podiatrist
  • Dalton, GA
  • NPI 1124552492

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1356500573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 BROADRICK DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202592",
            "telephone_number": "706-278-5558",
            "fax_number": "706-278-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 BROADRICK DR",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307202592",
            "telephone_number": "706-278-5558",
            "fax_number": "706-278-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN J LAND IV PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "LAND",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-278-5558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD000679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "480027427",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UMWA",
            "identifier": "1440694",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000828385A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "3351905",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "3124909",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "52432145",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Nicole Jinright, NP-C
• Stephen C. Jo, MD
• Jodi'S Enterprises, Inc.
• Suzanne Marie Johannes, OD
• John Allen Counseling LLC
• John W. Looper Jr. Speech & Hearing Clinic
• Amirah B Johnson, M.D.
• Ashley Johnson
• Ashley E Johnson, MCD, CCC-SLP
• Bruce L Johnson, O.D.

• All providers in Dalton, GA
• Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.