Diabetic Footcare Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

4537110001 Issued in GA

Legal business name

DIABETIC FOOTCARE INC

Practice address

1866 Old Savannah Rd
Midville, GA 30441-4420

Phone

(478) 589-7807

Fax

(478) 589-7923

NPI assigned

May 18, 2007

Last updated

Aug 22, 2020By 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

Mary Sue Faircloth

Title

Owner

Phone

(478) 589-7807

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447468012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1866 OLD SAVANNAH RD",
            "city": "MIDVILLE",
            "state": "GA",
            "postal_code": "304414420",
            "telephone_number": "478-589-7807",
            "fax_number": "478-589-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 OLD SAVANNAH RD",
            "city": "MIDVILLE",
            "state": "GA",
            "postal_code": "304414420",
            "telephone_number": "478-589-7807",
            "fax_number": "478-589-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETIC FOOTCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAIRCLOTH",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-589-7807"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "4537110001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.