NPIMap

Organization Active NPI

Vicki Anton Anthens DPM PC

Doing business as athens podiatry group

  • Podiatrist
  • Brownstown TWP, MI
National Provider Identifier
1508862590
Registry record updated Jul 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
VICKI ANTON ANTHENS DPM PC
Doing business as
athens podiatry group
Practice address
19723 Allen Rd
Brownstown TWP, MI 48183-1021
Phone
(734) 479-8383
Fax
(734) 479-8382
NPI assigned
Jun 23, 2005
Last updated
Jul 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2008

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

Authorized official

Name
Mrs. Vicki Maria Antonathens, DPMNPI 1407852510
Title
President
Phone
(734) 479-8383

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
Podiatrist 213E00000X Primary

Addresses

Primary practice location

19723 Allen Rd
Brownstown TWP, MI 48183-1021

Mailing address

19723 Allen Rd
Brownstown TWP, MI 48183-1021
Phone (734) 479-8383

Other identifiers 1

IdentifierTypeStateIssuer
480H278050OtherMIBCBSM

Other names 1

  • athens podiatry group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050520000551 MI Part B Supplier - Clinic/Group Practice 8921049800 Receives reassigned benefits from 5 practitioners
Practice locations: Brownstown TWP, MI; Flat Rock, MI

National Provider Directory

National Provider Directory

Locations

19723 Allen Rd
Brownstown Twp, MI 48183
Phone (734) 479-8383

14835 Telegraph Rd
Flat Rock, MI 48134
Phone (734) 782-5800

Practitioners & affiliated clinicians

Practitioners 7

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": "1119484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1508862590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19723 ALLEN RD",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481831021",
            "telephone_number": "734-479-8383",
            "fax_number": "734-479-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19723 ALLEN RD",
            "city": "BROWNSTOWN TWP",
            "state": "MI",
            "postal_code": "481831021",
            "telephone_number": "734-479-8383",
            "fax_number": "734-479-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VICKI ANTON ANTHENS DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-23",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "ANTONATHENS",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-479-8383",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "480H278050",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "athens podiatry group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brownstown TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.