Grand Traverse Foot & Ankle Center P.C.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

5901001664 Issued in MI

Legal business name

GRAND TRAVERSE FOOT & ANKLE CENTER P.C.

Practice address

4246 N. Three Mile Rd.
Traverse City, MI 49686

Phone

(231) 922-9100

Fax

(231) 922-9180

NPI assigned

Dec 13, 2007

Last updated

Jul 10, 2013By 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

Theresa Marie Zywicki

Title

Office Manager

Phone

(231) 922-9100

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

Enrollment records 2

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.

• Ronald Kevin Olm, DPM, FACFAS, C-PED

  • Podiatrist
  • Traverse City, MI
  • NPI 1356344741
  Medicare reassignment NPD

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373414400000",
    "number": "1396928297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4246 N. THREE MILE RD.",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49686",
            "telephone_number": "231-922-9100",
            "fax_number": "231-922-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4246 N. THREE MILE RD.",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "49686",
            "telephone_number": "231-922-9100",
            "fax_number": "231-922-9180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND TRAVERSE FOOT & ANKLE CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-13",
        "last_updated": "2013-07-10",
        "status": "A",
        "authorized_official_last_name": "ZYWICKI",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "231-922-9100"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MI",
            "license": "5901001664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132893049",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grand Traverse County Commission on Aging
• Grand Traverse County Health Department
• Grand Traverse County Health Department
• Grand Traverse Dental Care, PC
• Grand Traverse Family Chiropractic PLLC (Grand Traverse Family Chiropractic)
• Grand Traverse Heart Institute (Grand Traverse Heart Associates)
• Grand Traverse Industries, Inc.
• Grand Traverse Internists, PC
• Grand Traverse Nutrition, LLC
• Grand Traverse Ophthalmology Clinic PC

• Podiatrist in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Podiatrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; 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.