Active NPI
Foot and Wound Institute of the South
- Podiatric Clinic/Center
- Monticello, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatric Clinic/Center
- License
- 80070
- Legal business name
- FOOT AND WOUND INSTITUTE OF THE SOUTH
- Practice address
- 157 Fe Sellers Highway
Monticello, MS 39654 - Phone
- (601) 362-3158
- Fax
- (318) 336-4052
- NPI assigned
- Feb 28, 2008
- Last updated
- Apr 20, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gerard Guerin Jr.
- Title
- Owner
- Phone
- (985) 345-6616
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatric Clinic/Center | 261QP1100X | 80070 | MS | Primary |
Addresses
Primary practice location
157 Fe Sellers Highway
Monticello, MS 39654
Mailing address
157 Sellers Hwy
Monticello, MS 39654
Phone (601) 362-3158
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00015989 | Medicaid | MS | |
| 1323462 | Medicaid | LA |
National Provider Directory
National Provider Directory- Tax ID family
- Foot and Wound Institute of the South
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- McComb, MS
- NPI 1538307863
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Podiatrist
- Dallas, TX
- NPI 1629098660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204156800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1208649600000",
"number": "1447429089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "157 SELLERS HWY",
"city": "MONTICELLO",
"state": "MS",
"postal_code": "39654",
"telephone_number": "601-362-3158"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "157 FE SELLERS HIGHWAY",
"city": "MONTICELLO",
"state": "MS",
"postal_code": "39654",
"telephone_number": "601-362-3158",
"fax_number": "318-336-4052"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOOT AND WOUND INSTITUTE OF THE SOUTH",
"organizational_subpart": "NO",
"enumeration_date": "2008-02-28",
"last_updated": "2008-04-20",
"status": "A",
"authorized_official_last_name": "GUERIN",
"authorized_official_first_name": "GERARD",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "985-345-6616",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "261QP1100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Podiatric",
"state": "MS",
"license": "80070",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00015989",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1323462",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Monticello, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.