Foot and Ankle Wellness Center

Primary specialty

PodiatristTaxonomy code 213E00000X

License

GA000916 Issued in GA

Legal business name

FOOT AND ANKLE WELLNESS CENTER

Practice address

416 Pirkle Ferry Rd Ste J500
Cumming, GA 30040-9221

Phone

(678) 513-8777

Fax

(678) 513-8999

NPI assigned

Sep 12, 2007

Last updated

Sep 12, 2007By 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

Keith MillerNPI 1942354485

Title

Owner

Phone

(678) 513-8777

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

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.

• Keith A Miller

  • Podiatrist
  • Cumming, GA
  • NPI 1942354485
  NPD Authorized official

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1366637399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 PIRKLE FERRY RD STE J500",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300409221",
            "telephone_number": "678-513-8777",
            "fax_number": "678-513-8999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 PIRKLE FERRY RD STE J500",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300409221",
            "telephone_number": "678-513-8777",
            "fax_number": "678-513-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-513-8777"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "GA000916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10059160",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N327176",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00290978",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Peter Edward Fong, M.D.
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• Maryann Forbes, NP-C
• Ashley Kathleen Ford, FNP-C
• Briana Ford, DO
• Cheryl L. Fordham, M.S., LPC, NBCCH

• Podiatrist in Cumming, GA
• Providers in Cumming, GA by specialty
• Podiatrist in Georgia

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