Organization Active NPI

Ohio Foot and Ankle Center LLC

  • Foot & Ankle Surgery Podiatrist
  • Fairlawn, OH
National Provider Identifier
1508126814
Registry record updated Feb 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
OHIO FOOT AND ANKLE CENTER LLC
Practice address
2660 W Market St
Ste# 101
Fairlawn, OH 44333-4209
Phone
(330) 867-9303
Fax
(330) 867-9304
NPI assigned
May 21, 2012
Last updated
Feb 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2014

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

Authorized official

Name
Machelle Giordon
Title
Credentialing
Phone
(330) 723-2111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X Primary

Addresses

Primary practice location

2660 W Market St
Ste# 101
Fairlawn, OH 44333-4209

Mailing address

2660 W Market St
Ste# 101
Fairlawn, OH 44333-4209
Phone (330) 867-9303

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041007000296 OH Part B Supplier - Clinic/Group Practice 2466411244 Receives reassigned benefits from 2 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Canton, OH; Rittman, OH; Stow, OH

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2660 W Market St
Ste 101
Fairlawn, OH 44333
Phone (330) 867-9303

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393545600000",
    "number": "1508126814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2660 W MARKET ST",
            "address_2": "STE# 101",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334209",
            "telephone_number": "330-867-9303",
            "fax_number": "330-867-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2660 W MARKET ST",
            "address_2": "STE# 101",
            "city": "FAIRLAWN",
            "state": "OH",
            "postal_code": "443334209",
            "telephone_number": "330-867-9303",
            "fax_number": "330-867-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OHIO FOOT AND ANKLE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-21",
        "last_updated": "2014-02-28",
        "status": "A",
        "authorized_official_last_name": "GIORDON",
        "authorized_official_first_name": "MACHELLE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "330-723-2111"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairlawn, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; 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.