NPIMap

Organization Active NPI

Shores Podiatry Associates, P.C.

  • Foot & Ankle Surgery Podiatrist
  • Roseville, MI
National Provider Identifier
1447204151
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
SHORES PODIATRY ASSOCIATES, P.C.
Practice address
20905 E 12 Mile Rd
Suite 100
Roseville, MI 48066-6501
Phone
(586) 772-3500
Fax
(586) 772-6540
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Authorized official

Name
James McCarty, DPM
Title
Doctor
Phone
(586) 772-3500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X MI Primary

Addresses

Primary practice location

20905 E 12 Mile Rd
Suite 100
Roseville, MI 48066-6501

Mailing address

20905 E 12 Mile Rd
Suite 100
Roseville, MI 48066-6501
Phone (586) 772-3500

Other identifiers 2

IdentifierTypeStateIssuer
0E07641OtherMIBCBS
CE4140OtherMIRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040722000482 MI Part B Supplier - Clinic/Group Practice 7012997893 Receives reassigned benefits from 9 practitioners
Practice locations: Lenox, MI; Macomb, MI; Roseville, MI

National Provider Directory

National Provider Directory

Locations

22151 Moross Rd
Ste 213
Detroit, MI 48236

22151 Moross Rd
Ste 335
Detroit, MI 48236
Phone (313) 343-0304

36555 26 Mile Rd
Ste 2600
Lenox, MI 48048
Phone (586) 772-3500

15959 Hall Rd
Ste 204
Macomb, MI 48044
Phone (586) 566-3717

15959 Hall Rd
Ste 109
Macomb, MI 48044
Phone (586) 772-3500

48801 Romeo Plank Rd
Ste 2
Macomb, MI 48044
Phone (586) 772-3500

Practitioners & affiliated clinicians

Practitioners 10

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": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1447204151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20905 E 12 MILE RD",
            "address_2": "SUITE 100",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480666501",
            "telephone_number": "586-772-3500",
            "fax_number": "586-772-6540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20905 E 12 MILE RD",
            "address_2": "SUITE 100",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480666501",
            "telephone_number": "586-772-3500",
            "fax_number": "586-772-6540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORES PODIATRY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "MCCARTY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "586-772-3500",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0E07641",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CE4140",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.