Organization Active NPI

Sole Purpose Podiatry, LLC

  • Podiatrist
  • Columbia, MD
National Provider Identifier
1366078842
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
SOLE PURPOSE PODIATRY, LLC
Practice address
8900 Columbia 100 Pkwy
Columbia, MD 21045-2336
Phone
(302) 526-9582
NPI assigned
Mar 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Authorized official

Name
Dr. Fanta Vaughn Morgan-Kitson, DPMNPI 1376756080
Title
Owner/Podiatrist
Phone
(302) 538-0575

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

8900 Columbia 100 Pkwy
Columbia, MD 21045-2336

Mailing address

PO Box 813
Smyrna, DE 19977-0813
Phone (302) 526-9582

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200602000616 DE Part B Supplier - Clinic/Group Practice 4082035993 Receives reassigned benefits from 1 practitioner
Practice locations: Clayton, DE

National Provider Directory

National Provider Directory

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": "1584403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1366078842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 813",
            "city": "SMYRNA",
            "state": "DE",
            "postal_code": "199770813",
            "telephone_number": "302-526-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8900 COLUMBIA 100 PKWY",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452336",
            "telephone_number": "302-526-9582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOLE PURPOSE PODIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-17",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A",
        "authorized_official_last_name": "MORGAN-KITSON",
        "authorized_official_first_name": "FANTA",
        "authorized_official_middle_name": "VAUGHN",
        "authorized_official_title_or_position": "OWNER/PODIATRIST",
        "authorized_official_telephone_number": "302-538-0575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.