Organization Active NPI

North Atlantic Podiatry, P.C.

  • Primary Podiatric Medicine Podiatrist
  • Medford, MA
National Provider Identifier
1437339868
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
Legal business name
NORTH ATLANTIC PODIATRY, P.C.
Practice address
83 Sheridan Ave
Medford, MA 02155-4042
Phone
(978) 458-4011
Fax
(978) 458-4020
NPI assigned
Nov 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Wayne McCulloughNPI 1033284179
Title
DPM
Phone
(978) 458-4011

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Primary Podiatric Medicine PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213EP1101X Primary
Sports Medicine PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0000X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X

Addresses

Primary practice location

83 Sheridan Ave
Medford, MA 02155-4042

Mailing address

83 Sheridan Ave
Medford, MA 02155-4042
Phone (978) 458-4011

National Provider Directory

National Provider Directory

Locations

24 Merrimack St
#421
Lowell, MA 01852
Phone (978) 458-4011

24 Merrimack St
Ste 421
Lowell, MA 01852
Phone (508) 777-5651

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1437339868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 SHERIDAN AVE",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554042",
            "telephone_number": "978-458-4011",
            "fax_number": "978-458-4020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 SHERIDAN AVE",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554042",
            "telephone_number": "978-458-4011",
            "fax_number": "978-458-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH ATLANTIC PODIATRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "MCCULLOUGH",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "978-458-4011"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

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