NPIMap

Organization Active NPI

Village Podiatry Group, LLC.

  • Podiatrist
  • Fort Oglethorpe, GA
National Provider Identifier
1467985382
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
VILLAGE PODIATRY GROUP, LLC.
Practice address
2368 Battlefield Pkwy
Fort Oglethorpe, GA 30742-4030
Phone
(706) 861-6200
Fax
(706) 861-6222
NPI assigned
Apr 7, 2017
Organization subpart
Yes
Parent organization
EXTREMITY HEALTHCARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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

Authorized official

Name
Mitchell P. Hilsen, D.P.M.
Title
C.O.O.
Phone
(678) 426-2171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

2368 Battlefield Pkwy
Fort Oglethorpe, GA 30742-4030

Mailing address

900 Circle 75 Pkwy. SE
Suite 900
Atlanta, GA 30339-3039
Phone (678) 426-2171

Other names 1

  • d/b/a Village Podiatry Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170606001411 GA DME Supplier - Physician - Podiatry 4587646971 Practice locations: Fort Oglethorpe, GA

National Provider Directory

National Provider Directory
Tax ID family
Village Podiatry Group LLC35 organizations share this tax ID, including this one

Other organizations with this tax ID 34

Organizations that report the same tax identification number in the National Provider Directory.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491523200000",
    "number": "1467985382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CIRCLE 75 PKWY. SE",
            "address_2": "SUITE 900",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393039",
            "telephone_number": "678-426-2171",
            "fax_number": "404-446-1957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2368 BATTLEFIELD PKWY",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307424030",
            "telephone_number": "706-861-6200",
            "fax_number": "706-861-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE PODIATRY GROUP, LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EXTREMITY HEALTHCARE, INC.",
        "enumeration_date": "2017-04-07",
        "last_updated": "2017-04-07",
        "status": "A",
        "authorized_official_last_name": "HILSEN",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "678-426-2171",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "d/b/a Village Podiatry Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Oglethorpe, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2017; 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.