NPIMap

Organization Active NPI

North Central Penn Podiatry PC

  • Podiatrist
  • Wellsboro, PA
National Provider Identifier
1366435653
Registry record updated Nov 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
SC0018534 Issued in PA
Legal business name
NORTH CENTRAL PENN PODIATRY PC
Practice address
103 West Ave
Wellsboro, PA 16901-1358
Phone
(570) 724-5297
Fax
(570) 724-8793
NPI assigned
Aug 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2007

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

Authorized official

Name
Stevan J Anselmi, DPMNPI 1336135458
Title
Owner
Phone
(570) 724-5297

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 SC0018534 PA Primary

Addresses

Primary practice location

103 West Ave
Wellsboro, PA 16901-1358

Mailing address

103 West Ave
Wellsboro, PA 16901-1358
Phone (570) 724-5297

Other identifiers 3

IdentifierTypeStateIssuer
CM5849OtherPATRAVELERS MEDICARE
0011971430002MedicaidPA
593990OtherHIGHMARK BS

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": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194825600000",
    "number": "1366435653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 WEST AVE",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169011358",
            "telephone_number": "570-724-5297",
            "fax_number": "570-724-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 WEST AVE",
            "city": "WELLSBORO",
            "state": "PA",
            "postal_code": "169011358",
            "telephone_number": "570-724-5297",
            "fax_number": "570-724-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CENTRAL PENN PODIATRY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2007-11-12",
        "status": "A",
        "authorized_official_last_name": "ANSELMI",
        "authorized_official_first_name": "STEVAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "570-724-5297",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "PA",
            "license": "SC0018534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "CM5849",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011971430002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS",
            "identifier": "593990",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellsboro, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.