Foot Essentials LLC

Organization Active NPI Podiatrist · Signal Mountain, TN

NPI 1376017871 · NPPES record last updated Jan 30, 2019

Key facts

NPI
1376017871
Entity type
Organization (NPI type 2)
Primary specialty
Podiatrist 213E00000X
Legal business name
FOOT ESSENTIALS LLC
Practice address
635 Alexian Way
Signal Mountain, TN 37377-1958
Phone
(309) 826-3774
NPI assigned
Jan 17, 2019
Organization subpart
No

Authorized official

Name
Rachna Gupta, DPM
Title
Owner
Phone
(309) 826-3774

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20190318001366 TN Part B Supplier - Clinic/Group Practice 7416297080 Receives reassigned benefits from 1 practitioner
Practice locations: Signal Mountain, TN

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist
Group: 193400000X SINGLE SPECIALTY GROUP
213E00000X Yes

Addresses

Primary practice location

635 Alexian Way
Signal Mountain, TN 37377-1958

Mailing address

PO Box 21489
Chattanooga, TN 37424-0489
Phone (309) 826-3774

Other providers in Signal Mountain, TN

All providers in Signal Mountain, TN · Podiatrist in Tennessee

Sources for this page

Verify at the official NPI Registry.