Golden Footprint LLC

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

GOLDEN FOOTPRINT LLC

Practice address

108 S Bragg St
Suite 6
Warrenton, NC 27589-2048

Phone

(919) 271-8146

Fax

(919) 460-0776

NPI assigned

Jul 8, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Leonard Smith

Title

Ceo

Phone

(919) 271-8146

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1508029604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "718 N HARRISON AVE",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275135431",
            "telephone_number": "919-271-8146",
            "fax_number": "919-460-0776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S BRAGG ST",
            "address_2": "SUITE 6",
            "city": "WARRENTON",
            "state": "NC",
            "postal_code": "275892048",
            "telephone_number": "919-271-8146",
            "fax_number": "919-460-0776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN FOOTPRINT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-271-8146",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.