Personal Footcare LLC

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

0103000377 Issued in VA

Legal business name

PERSONAL FOOTCARE LLC

Practice address

2020 Wakefield Ave
Petersburg, VA 23805-2112

Phone

(804) 732-1211

Fax

(804) 733-5946

NPI assigned

Mar 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Winfred Person, D.P.M.NPI 1154324879

Title

President

Phone

(804) 732-1211

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Personal Footcare LLC

  • Durable Medical Equipment & Medical Supplies
  • South Hill, VA
  • NPI 1861746059
  NPPES parent name

Practitioners 2

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

• Samuel Winfred Person, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • Petersburg, VA
  • NPI 1154324879
  Medicare reassignment NPD Authorized official
• Carlos Myers, DPM

  • Podiatrist
  • Hampton, VA
  • NPI 1790210664
  Medicare reassignment NPD

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715990400000",
    "number": "1487613030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 WAKEFIELD AVE",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238052112",
            "telephone_number": "804-732-1211",
            "fax_number": "804-733-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 WAKEFIELD AVE",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238052112",
            "telephone_number": "804-732-1211",
            "fax_number": "804-733-5946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "420 Durant St",
            "address_purpose": "LOCATION",
            "city": "South Hill",
            "state": "VA",
            "postal_code": "239701614",
            "country_code": "US",
            "telephone_number": "434-447-6988",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PERSONAL FOOTCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2024-05-18",
        "certification_date": "2024-05-18",
        "status": "A",
        "authorized_official_last_name": "PERSON",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "WINFRED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "804-732-1211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "VA",
            "license": "0103000377",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30015890910001",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009331409",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30015176580001",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Woodford Perez, LCSW
• Taylor Perkinson
• Samuel Winfred Person, D.P.M.
• Personal Foot Care Group (Personal Foot Care)
• Personal Foot Care II, LLC
• Petersburg Adult Healthcare
• Petersburg Case Management & Services
• Petersburg Clinic Company LLC
• Petersburg Complete Dental Care PLLC
• Petersburg Dermatology, PC

• Primary Podiatric Medicine Podiatrist in Petersburg, VA
• Providers in Petersburg, VA by specialty
• Primary Podiatric Medicine Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2024; 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.