Island Podiatry PA

Primary specialty

PodiatristTaxonomy code 213E00000X

License

591 Issued in SC

Legal business name

ISLAND PODIATRY PA

Practice address

3 Celadon Dr
Suite a
Beaufort, SC 29907-2695

Phone

(843) 379-9913

Fax

(843) 379-9914

NPI assigned

Apr 6, 2009

Last updated

Sep 30, 2014By 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

Jill C. Blau, DPM

Title

Managing Member

Phone

(843) 379-9913

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1238976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412035200000",
    "number": "1467694430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 CELADON DR",
            "address_2": "SUITE A",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299072695",
            "telephone_number": "843-379-9913",
            "fax_number": "843-379-9914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 CELADON DR",
            "address_2": "SUITE A",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299072695",
            "telephone_number": "843-379-9913",
            "fax_number": "843-379-9914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLAND PODIATRY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-06",
        "last_updated": "2014-09-30",
        "status": "A",
        "authorized_official_last_name": "BLAU",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "843-379-9913",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "SC",
            "license": "591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Internal Medicine Healthcare, P.a.
• Vincent Irish, M.D.
• Jennifer Irlbacher, LPCA
• Patricia A. Irvine, CRNA
• Anika Islam, DMD
• Lisa Chanel Jackson, M.D.
• William M. Jackson, MD
• Catherine Jacobs, RN
• Austin Michael Jacobson, PTA
• Natalie Renee Jacques, PHARM.D.

• Podiatrist in Beaufort, SC
• Providers in Beaufort, SC by specialty
• Podiatrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.