Greenville Foot & Ankle Center PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

239 Issued in NC

Legal business name

GREENVILLE FOOT & ANKLE CENTER PLLC

Practice address

2409 S Charles Blvd
Greenville, NC 27858-5925

Phone

(252) 321-0203

Fax

(252) 353-5669

NPI assigned

Sep 13, 2005

Last updated

Feb 8, 2008By 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

Paul J Civatte, DPM

Title

Member/Manager

Phone

(252) 321-0203

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1126569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202428800000",
    "number": "1437144896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2409 S CHARLES BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585925",
            "telephone_number": "252-321-0203",
            "fax_number": "252-353-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2409 S CHARLES BLVD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278585925",
            "telephone_number": "252-321-0203",
            "fax_number": "252-353-5669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENVILLE FOOT & ANKLE CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-13",
        "last_updated": "2008-02-08",
        "status": "A",
        "authorized_official_last_name": "CIVATTE",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEMBER/MANAGER",
        "authorized_official_telephone_number": "252-321-0203",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/STATE",
            "identifier": "08015",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7908015",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Greenville, NC
• Providers in Greenville, NC by specialty
• Foot & Ankle Surgery Podiatrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 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.