Auburn Opelika Family Footcare

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

132 Issued in AL

Legal business name

AUBURN OPELIKA FAMILY FOOTCARE

Practice address

2121 Executive Park Dr
Opelika, AL 36801-6041

Phone

(334) 705-0544

Fax

(334) 705-0548

NPI assigned

Aug 30, 2007

Organization subpart

No

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

• Brenda L Rasberry - Casselberry, DPM

  • Podiatrist
  • Opelika, AL
  • NPI 1750484358

  AL, Podiatrist

  Medicare reassignment NPD

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

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

Authorized official

Name

Dr. Brenda L Casselberry, DPM

Title

President / Physician

Phone

(334) 705-0544

Specialties & licenses 1

Addresses

Other identifiers 6

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1376737528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1268",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368311268",
            "telephone_number": "334-705-0544",
            "fax_number": "334-705-0548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 EXECUTIVE PARK DR",
            "city": "OPELIKA",
            "state": "AL",
            "postal_code": "368016041",
            "telephone_number": "334-705-0544",
            "fax_number": "334-705-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUBURN OPELIKA FAMILY FOOTCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "CASSELBERRY",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT / PHYSICIAN",
        "authorized_official_telephone_number": "334-705-0544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "AL",
            "license": "132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE R/R  PIN",
            "identifier": "480013769",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAL- TUSKEGEE",
            "identifier": "51540360",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1750484358",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAL--OPELIKA",
            "identifier": "51540725",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE R/R GROUP PIN",
            "identifier": "CM3112",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "529912550",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Amanda Elizabeth Austin, M.D.
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• Robert Michael Azar, ALC

• All providers in Opelika, AL
• Podiatric Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.