Serenity Podiatric Concierge, LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

POD001275 Issued in GA

Legal business name

SERENITY PODIATRIC CONCIERGE, LLC

Practice address

32 Fenwick PL
Atlanta, GA 30328-1037

Phone

(347) 281-2620

NPI assigned

Apr 18, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Sarepta Isaac, DPMNPI 1316387038

Title

Ceo

Phone

(347) 281-2620

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sarepta Isaac, DPM

  • Podiatrist
  • Matthews, NC
  • NPI 1316387038

  GA

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1460937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460937600000",
    "number": "1467806315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 FENWICK PL",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303281037",
            "telephone_number": "347-281-2620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 FENWICK PL",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303281037",
            "telephone_number": "347-281-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENITY PODIATRIC CONCIERGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-18",
        "last_updated": "2016-04-18",
        "status": "A",
        "authorized_official_last_name": "ISAAC",
        "authorized_official_first_name": "SAREPTA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "347-281-2620",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "POD001275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Alexis Seres, RN, BSN, CRNA
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• Podiatrist in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; 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.