Organization Active NPI

Performance Footcare

Doing business as Specialty Orthotics

  • Orthotist
  • Charlotte, NC
National Provider Identifier
1407350507
Registry record updated Sep 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OrthotistTaxonomy code 222Z00000X
Legal business name
PERFORMANCE FOOTCARE
Doing business as
Specialty Orthotics
Practice address
2024 Randolph Rd
Charlotte, NC 28207-1216
Phone
(704) 945-7790
Fax
(980) 207-4812
NPI assigned
Mar 22, 2018
Last updated
Sep 3, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2024

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

Authorized official

Name
Ms. Grace Turner
Title
Clinic Director
Phone
(704) 945-7790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X NU Primary

Addresses

Primary practice location

2024 Randolph Rd
Charlotte, NC 28207-1216

Mailing address

2024 Randolph Rd
Charlotte, NC 28207-1216
Phone (704) 945-7790

Other names 1

  • Specialty Orthotics Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725321600000",
    "number": "1407350507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2024 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071216",
            "telephone_number": "704-945-7790",
            "fax_number": "980-207-4812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071216",
            "telephone_number": "704-945-7790",
            "fax_number": "980-207-4812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE FOOTCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-22",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "704-945-7790",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialty Orthotics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; 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.