Georgia Foot & Ankle, P.C.
Organization Active NPI Podiatrist · Madison, GA
NPI 1376718148 · NPPES record last updated Apr 25, 2008
Key facts
- NPI
- 1376718148
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Podiatrist 213E00000X
- License
- POD000747 (GA)
- Legal business name
- GEORGIA FOOT & ANKLE, P.C.
- Practice address
- 1075 S Main Street
Suite 200
Madison, GA 30650-2049 - Phone
- (770) 786-0070
- Fax
- (770) 786-9744
- NPI assigned
- Apr 23, 2008
- Organization subpart
- No
Authorized official
- Name
- Steven Carter, DPM
- Title
- Owner
- Phone
- (770) 786-0070
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Practitioners 6
-
Steven Ray Carter, DPM
-
Craig A. Camasta, DPM
-
Suzette Andrean Clements, D.P.M.,
-
Jayson B. Phelps, DPM
-
Jennifer S Price, DPM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040420001147 | GA | Part B Supplier - Clinic/Group Practice | 1254326937 |
Receives reassigned benefits from 1 practitioner 1 other NPI on this enrollment Practice locations: Covington, GA |
National Provider Directory
Locations
3160 Elm St NE
Covington, GA 30014
Phone (770) 786-0070
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist |
213E00000X | POD000747 | GA | Yes |
Addresses
Primary practice location
1075 S Main Street
Suite 200
Madison, GA 30650-2049
Mailing address
3160 Elm Street
Covington, GA 30014-2461
Phone (770) 786-0070
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000746611D | Medicaid | GA | |
| 000746611A | Medicaid | GA |
Other providers in Madison, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.