South Island Podiatry Specialists,PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

N0-3889 Issued in NY

Legal business name

SOUTH ISLAND PODIATRY SPECIALISTS,PC

Practice address

1641 Route 112
Medford, NY 11763-3635

Phone

(631) 447-0800

Fax

(631) 447-0801

NPI assigned

Dec 20, 2006

Last updated

Jun 13, 2008By 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

Dr. Wayne Joseph Bodamer, D.P.M.NPI 1457317562

Title

President

Phone

(631) 447-0800

Specialties & licenses 1

Addresses

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.

• Wayne Joseph Bodamer, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Smithtown, NY
  • NPI 1457317562
  Authorized official Same address or phone

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1376607713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1641 ROUTE 112",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117633635",
            "telephone_number": "631-447-0800",
            "fax_number": "631-447-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1641 ROUTE 112",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117633635",
            "telephone_number": "631-447-0800",
            "fax_number": "631-447-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH ISLAND PODIATRY SPECIALISTS,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "BODAMER",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-447-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NY",
            "license": "N0-3889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Marie Smith
• Shalah Smith
• Sydney Smith
• Shaun Lamont Snead
• Angela Sorice, NPP
• Tracey Marie Southard
• Jonah Peter Spaeth, DDS
• Natale F Spata, D.C.
• Felicia Splaine
• Crystal Lynn Stamm, RN

• Foot & Ankle Surgery Podiatrist in Medford, NY
• Providers in Medford, NY by specialty
• Foot & Ankle Surgery Podiatrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.