Active NPI
Gregory James Cardinal, DPM
- Podiatrist
- Alexandria, VA
National Provider Identifier
1356603922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 0103301144
- Practice address
- 2201 Mount Vernon Ave Ste 105
Alexandria, VA 22301 - Phone
- (703) 879-5155
- Fax
- (703) 879-5951
- NPI assigned
- Jun 11, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | PO1000119 | DC | |
| Podiatrist | 213E00000X | 01579 | MD | |
| Podiatrist | 213E00000X | 0103301144 | VA | Primary |
Addresses
Primary practice location
2201 Mount Vernon Ave Ste 105
Alexandria, VA 22301
Mailing address
1015 Vernon St
Alexandria, VA 22314-1349
Phone (612) 382-6490
Other practice location 1
10 N Greene St
Baltimore, MD 21201-1524
Phone (410) 605-7000 ext. 4167
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 1, 2016 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PO1000119 | DC | MD | Podiatrist |
| 01579 | MD | MD | Podiatrist |
| 0103301144 | VA | MD | Podiatrist |
Interoperability endpoints
- gregory.cardinal.1@18665.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1533254400000",
"number": "1356603922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1015 VERNON ST",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "223141349",
"telephone_number": "612-382-6490",
"fax_number": "703-879-5951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 MOUNT VERNON AVE STE 105",
"city": "ALEXANDRIA",
"state": "VA",
"postal_code": "22301",
"telephone_number": "703-879-5155",
"fax_number": "703-879-5951"
}
],
"practiceLocations": [
{
"address_1": "10 N Greene St",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212011524",
"country_code": "US",
"telephone_number": "410-605-7000 x4167",
"fax_number": "410-605-7919",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARDINAL",
"first_name": "GREGORY",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-11",
"last_updated": "2018-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "DC",
"license": "PO1000119",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "MD",
"license": "01579",
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "VA",
"license": "0103301144",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2018; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.