Tidewater Foot & Ankle Center, PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

TIDEWATER FOOT & ANKLE CENTER, PC

Practice address

760 Independence Blvd
Virginia Beach, VA 23455-6206

Phone

(757) 497-7575

NPI assigned

Dec 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. William P. Grant, DPMNPI 1982706685

Title

Owner

Phone

(757) 497-7575

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in VA2 enrollments

Enrollment records 2

Locations

Practitioners 9

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

• William P Grant, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Virginia Beach, VA
  • NPI 1982706685
  Medicare reassignment Care Compare group NPD Authorized official
• Lisa Marie Grant-McDonald, DPM

  • Foot & Ankle Surgery Podiatrist
  • Stafford, VA
  • NPI 1831509942
  Medicare reassignment Care Compare group NPD
• Junaid Mohammed Zahiruddin Khazi

  • Podiatrist
  • Rockford, IL
  • NPI 1619558384

  VA

  Medicare reassignment NPD
• Zab'Di Lanette Sanchez Prada, DPM

  • Podiatrist
  • Vestal, NY
  • NPI 1295364404

  VA

  Medicare reassignment NPD
• Erin A Jerlin, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Chesapeake, VA
  • NPI 1720079080
  NPD (past)
• Dwayne Aubrey Jacobus, D.P.M.

  • Primary Podiatric Medicine Podiatrist
  • Columbia, SC
  • NPI 1295726172
  NPD (past)
• Renee Kukla Pietzsch, DPM

  • Podiatrist
  • Georgetown, TX
  • NPI 1649209503
  NPD (past)
• Harry S Tam, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Easton, PA
  • NPI 1235231945
  NPD (past)
• William Edward Daniel Yeaman, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Hagerstown, MD
  • NPI 1780808238
  NPD (past)

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242172800000",
    "number": "1497813158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55350",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234719350",
            "telephone_number": "757-497-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 INDEPENDENCE BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234556206",
            "telephone_number": "757-497-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIDEWATER FOOT & ANKLE CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2009-05-13",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-497-7575",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "480000051",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9301658",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tidewater Allergy and Asthma LLC (Tidewater Allery and Asthma)
• Tidewater Anesthesia Inc
• Tidewater Behavioral Services, LLC
• Tidewater Dental Studio PLLC (Tidewater Dental Studio)
• Tidewater Family Practice, P.C.
• Tidewater Hearing Center (Miracle Ear)
• Tidewater Home Health Care
• Tidewater Homespec, LLC
• Tidewater Integrated Medical Services, PLLC
• Tidewater Integrative Health PC

• Foot & Ankle Surgery Podiatrist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Foot & Ankle Surgery Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2009; 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.