Foot and Ankle Center of Southern Maine

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

FOOT AND ANKLE CENTER OF SOUTHERN MAINE

Practice address

75 Portland Rd
Kennebunk, ME 04043-6602

Phone

(207) 985-9888

Fax

(207) 985-3488

NPI assigned

Jan 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. David J Micca, DPM

Title

Owner

Phone

(207) 985-9888

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214784000000",
    "number": "1427234327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 PORTLAND RD",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436602",
            "telephone_number": "207-985-9888",
            "fax_number": "207-985-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PORTLAND RD",
            "city": "KENNEBUNK",
            "state": "ME",
            "postal_code": "040436602",
            "telephone_number": "207-985-9888",
            "fax_number": "207-985-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE CENTER OF SOUTHERN MAINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-06-30",
        "status": "A",
        "authorized_official_last_name": "MICCA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-985-9888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133240000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Fernandez, LCSW-CC
• William James Ferreira, PSYCHOLOGY EXAMINER
• Sara D Filliettaz, LCSW
• Chad A Flagg, MPT
• Foot & Ankle Center of Southern Maine
• Merilee Lacey Forbes-Kearns, MA MS CCC-SLP
• Lawrence Ford
• Crescentia Jean Fosmire, OTRL
• Mary Foster, OT
• Tina Lynn Fox, PTA

• Durable Medical Equipment & Medical Supplies in Kennebunk, ME
• Providers in Kennebunk, ME by specialty
• Durable Medical Equipment & Medical Supplies in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.