Organization Active NPI

Free State Podiatry

  • Foot & Ankle Surgery Podiatrist
  • Waldorf, MD
National Provider Identifier
1518644061
Registry record updated Sep 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FREE STATE PODIATRY
Practice address
50 Post Office Rd Ste 304
Waldorf, MD 20602-3704
Phone
(202) 258-4692
NPI assigned
Jun 28, 2023
Last updated
Sep 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2023

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

Authorized official

Name
Justin Pointer, PDMNPI 1659636082
Title
Owner
Phone
(202) 258-4692

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

50 Post Office Rd Ste 304
Waldorf, MD 20602-3704

Mailing address

PO Box 2850
Springfield, VA 22152-0850
Phone (202) 258-4692

National Provider Directory

National Provider Directory

Locations

50 Post Office Rd
Ste 304
Waldorf, MD 20602
Phone (240) 349-2448

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": "1687910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693785600000",
    "number": "1518644061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2850",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221520850",
            "telephone_number": "202-258-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 POST OFFICE RD STE 304",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023704",
            "telephone_number": "202-258-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREE STATE PODIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A",
        "authorized_official_last_name": "POINTER",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-258-4692",
        "authorized_official_credential": "PDM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2023; 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.