Augusta Foot & Ankle, PC

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

POD000842 Issued in GA

Legal business name

AUGUSTA FOOT & ANKLE, PC

Practice address

1416 Wainbrook Dr
Augusta, GA 30909-6289

Phone

(706) 262-3668

Fax

(706) 262-3670

NPI assigned

Nov 13, 2006

Last updated

Jul 3, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian Nathan Bennett, DPMNPI 1275639692

Title

Physician

Phone

(706) 312-3668

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Tax ID family

Augusta Foot Ankle2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Augusta Foot & Ankle, PC

  • Customized Equipment (DME)
  • Evans, GA
  • NPI 1568531119
  NPD tax ID

Practitioners 2

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.

• Brian Nathan Bennett, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Augusta, GA
  • NPI 1275639692
  Authorized official Same address or phone
• Christopher David Anna, DPM

  • Foot & Ankle Surgery Podiatrist
  • Augusta, GA
  • NPI 1144262148
  NPD (past)

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562112000000",
    "number": "1366513988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 WAINBROOK DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096289",
            "telephone_number": "706-262-3668",
            "fax_number": "706-262-3670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 WAINBROOK DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309096289",
            "telephone_number": "706-262-3668",
            "fax_number": "706-262-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUGUSTA FOOT & ANKLE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2019-07-03",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "NATHAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "706-312-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "GA",
            "license": "POD000842",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000812985B",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "TRAKnet",
            "affiliation": "N",
            "address_1": "1416 Wainbrook Dr",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309096289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Customized Equipment (DME) in Augusta, GA
• Providers in Augusta, GA by specialty
• Customized Equipment (DME) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; 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.