Wolf River Family Footcare PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

DPM0000000422 Issued in TN

Legal business name

WOLF RIVER FAMILY FOOTCARE PLLC

Practice address

7424 US Highway 64
Suite 119
Bartlett, TN 38133-3986

Phone

(901) 381-2800

Fax

(901) 381-2677

NPI assigned

Mar 5, 2007

Last updated

Jun 5, 2008By 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

Dr. Carl Joseph Siciliano, D.P.M.NPI 1922056431

Title

Owner Sole Member

Phone

(901) 381-2800

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 4

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.

• Adam C Macevoy, DPM

  • Foot & Ankle Surgery Podiatrist
  • Bartlett, TN
  • NPI 1073764692
  Medicare reassignment NPD
• Carl J Siciliano, DPM

  • Podiatrist
  • Bartlett, TN
  • NPI 1922056431
  Authorized official Same address or phone
• Lorena Beatriz Alvarez, D.P.M.

  • Podiatrist
  • Bartlett, TN
  • NPI 1578711131

  Foot & Ankle Surgery

  NPD (past)
• Robert James Wenzler, DPM

  • Foot Surgery Podiatrist
  • Southaven, MS
  • NPI 1518999630
  NPD (past)

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1457480683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7424 US HIGHWAY 64",
            "address_2": "SUITE 119",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381333986",
            "telephone_number": "901-381-2800",
            "fax_number": "901-381-2677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7424 US HIGHWAY 64",
            "address_2": "SUITE 119",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381333986",
            "telephone_number": "901-381-2800",
            "fax_number": "901-381-2677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOLF RIVER FAMILY FOOTCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "SICILIANO",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER SOLE MEMBER",
        "authorized_official_telephone_number": "901-381-2800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TN",
            "license": "DPM0000000422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID TYPE UNSPECIFIED",
            "identifier": "DG7179",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Wilson-Webster
• Elizabeth Bridget Windley, LCSW
• Jamie Lynn Wise, FNP-BC
• Robert Allen Witherspoon, DMD
• Wolf Chase Emergency Physicians
• William C Wolters, MD
• Joseph Kenneth Wong, MD
• Joseph Michael Wood, LCSW
• Michael J Woodbury, M.D.
• Caitlin Woodruff, PA-C

• Foot & Ankle Surgery Podiatrist in Bartlett, TN
• Providers in Bartlett, TN by specialty
• Foot & Ankle Surgery Podiatrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.