Organization Active NPI

Footwise Podiatry of W.VA. Inc.

  • Podiatrist
  • Morgantown, WV
National Provider Identifier
1447313564
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
193400000X Issued in WV
Legal business name
FOOTWISE PODIATRY OF W.VA. INC.
Practice address
1191 Pineview Dr Ste H1
Morgantown, WV 26505-0480
Phone
(304) 599-9000
Fax
(304) 599-4091
NPI assigned
Dec 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Authorized official

Name
Dr. Gordon A Miller, D.P.M.
Title
President Physician
Phone
(304) 599-9000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X 193400000X WV Primary
Primary Podiatric Medicine PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213EP1101X

Addresses

Primary practice location

1191 Pineview Dr Ste H1
Morgantown, WV 26505-0480

Mailing address

1191 Pineview Dr Ste H1
Morgantown, WV 26505-0480
Phone (304) 599-9000

Other identifiers 2

IdentifierTypeStateIssuer
001709829OtherWVBLUE CROSS
0008547000MedicaidWV

National Provider Directory

National Provider Directory

Locations

2000 Hampton Ctr
Ste B
Morgantown, WV 26505
Phone (304) 599-9000

1191 Pineview Dr
Ste H1
Morgantown, WV 26505
Phone (304) 599-9000

2000 Hampton Ctr
Morgantown, WV 26505
Phone (716) 471-3185

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": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652313600000",
    "number": "1447313564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1191 PINEVIEW DR STE H1",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265050480",
            "telephone_number": "304-599-9000",
            "fax_number": "304-599-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1191 PINEVIEW DR STE H1",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265050480",
            "telephone_number": "304-599-9000",
            "fax_number": "304-599-4091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTWISE PODIATRY OF W.VA. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "GORDON",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT PHYSICIAN",
        "authorized_official_telephone_number": "304-599-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "WV",
            "license": "193400000X",
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "001709829",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008547000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.