John Richard Iredale, D.P.M.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

51 Issued in NC

Practice address

4119 Capitol St
Durham, NC 27704-2153

Phone

(919) 477-0333

Fax

(919) 477-9389

NPI assigned

Sep 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1477549160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4119 CAPITOL ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042153",
            "telephone_number": "919-477-9333",
            "fax_number": "919-477-9389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4119 CAPITOL ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042153",
            "telephone_number": "919-477-0333",
            "fax_number": "919-477-9389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IREDALE",
        "first_name": "JOHN",
        "middle_name": "RICHARD",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-27",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NC",
            "license": "51",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC PROVIDER NUMBE",
            "identifier": "08092",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908092",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Grace Iorio, DPT, GCS
• Isabella Noel Ipsen
• Muhammad Waqas Iqbal, MD
• Ramona Irabor, CNS
• Kimberly Irby
• Matthew Irish, DPT
• Jayda Lynn Irizarry
• Christine Irons-Yeager, NP-C
• Dana B Irons, NP
• Jasmine Ti Irvin, PHD

• Foot & Ankle Surgery Podiatrist in Durham, NC
• Providers in Durham, NC by specialty
• Foot & Ankle Surgery Podiatrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2011; 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.