Southern Podiatry Foot and Ankle, PLLC

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

299 Issued in AL

Legal business name

SOUTHERN PODIATRY FOOT AND ANKLE, PLLC

Practice address

8000 Madison Blvd Ste D102-341
Madison, AL 35758-2031

Phone

(312) 752-7713

NPI assigned

Jul 13, 2009

Organization subpart

No

Name

Elyse N Tiller

Title

CPCS

Phone

(615) 956-7919

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

• Southern Podiatry Foot and Ankle LLC

  • Podiatrist
  • Homer, GA
  • NPI 1619112968
  NPD tax ID

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

• Rick Thornton, DPM

  • Podiatrist
  • Huntsville, AL
  • NPI 1518162858

  AL, Podiatrist, TN

  Medicare reassignment NPD

Medicare fee-for-service enrollment

Enrolled in AL, TN2 enrollments

Tax ID family

Southern Podiatry Foot and Ankle LLC (2 organizations share this tax ID)

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 12, 2024.

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733961600000",
    "number": "1497984397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 GRANDEVIEW BLVD APT 1928",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358242408",
            "telephone_number": "312-752-7713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 MADISON BLVD STE D102-341",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357582031",
            "telephone_number": "312-752-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PODIATRY FOOT AND ANKLE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-13",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A",
        "authorized_official_last_name": "TILLER",
        "authorized_official_first_name": "ELYSE",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CPCS",
        "authorized_official_telephone_number": "615-956-7919"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "AL",
            "license": "299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAL",
            "identifier": "510-49599",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112600",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lisa J Spears, LMT
• Speech Therapy Solutions
• Speechtime, Inc

• All providers in Madison, AL
• Foot Surgery Podiatrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.