NPIMap

Organization Active NPI

Atlantic Podiatry Associates DPM PA

  • Foot & Ankle Surgery Podiatrist
  • Palm Coast, FL
National Provider Identifier
1508487182
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
ATLANTIC PODIATRY ASSOCIATES DPM PA
Practice address
11 Florida Park Dr N
Palm Coast, FL 32137-3866
Phone
(386) 445-4734
Fax
(386) 445-8411
NPI assigned
May 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Authorized official

Name
James W RustNPI 1134141617
Title
Physician
Phone
(386) 274-3336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

11 Florida Park Dr N
Palm Coast, FL 32137-3866

Mailing address

1890 Lpga Blvd Ste 230
Daytona Beach, FL 32117-7131
Phone (386) 274-3336

Other identifiers 2

IdentifierTypeStateIssuer
4380280001OtherFLMEDICARE NSC
40973OtherFLMEDICARE PIN

National Provider Directory

National Provider Directory
Tax ID family
Atlantic Podiatry Associates DPM PA5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

11 Florida Park Dr N
Palm Coast, FL 32137
Phone (386) 251-5509

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596153600000",
    "number": "1508487182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD STE 230",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177131",
            "telephone_number": "386-274-3336",
            "fax_number": "386-274-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 FLORIDA PARK DR N",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321373866",
            "telephone_number": "386-445-4734",
            "fax_number": "386-445-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC PODIATRY ASSOCIATES DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-05",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A",
        "authorized_official_last_name": "RUST",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "386-274-3336"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NSC",
            "identifier": "4380280001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "40973",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Coast, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.