NPIMap

Organization Active NPI

Active Foot and Ankle Center, PC

  • Durable Medical Equipment & Medical Supplies
  • Chesapeake, VA
National Provider Identifier
1427464726
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0103301108 Issued in VA
Legal business name
ACTIVE FOOT AND ANKLE CENTER, PC
Practice address
369 Johnstown Rd
Chesapeake, VA 23322-5309
Phone
(757) 547-0123
Fax
(757) 547-2412
NPI assigned
Jul 8, 2014
Last updated
Oct 17, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Authorized official

Name
Dr. Munjed Salem, DPMNPI 1558681197
Title
President
Phone
(757) 547-0123

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0103301108 VA Primary

Addresses

Primary practice location

369 Johnstown Rd
Chesapeake, VA 23322-5309

Mailing address

369 Johnstown Rd
Chesapeake, VA 23322-5309
Phone (757) 547-0123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150518001841 VA DME Supplier - Physician - Podiatry 3678791837 Practice locations: Chesapeake, VA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Active Foot and Ankle Center PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697500800000",
    "number": "1427464726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "369 JOHNSTOWN RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233225309",
            "telephone_number": "757-547-0123",
            "fax_number": "757-547-2412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 JOHNSTOWN RD",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233225309",
            "telephone_number": "757-547-0123",
            "fax_number": "757-547-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE FOOT AND ANKLE CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-08",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A",
        "authorized_official_last_name": "SALEM",
        "authorized_official_first_name": "MUNJED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "757-547-0123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": "0103301108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; 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.