Advanced Foot & Ankle Center, PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

001752814 Issued in NC

Legal business name

ADVANCED FOOT & ANKLE CENTER, PC

Practice address

137 Professional Park Dr.
Suite C
Mooresville, NC 28117

Phone

(704) 662-8336

Fax

(704) 662-8525

NPI assigned

Nov 30, 2006

Last updated

May 26, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kenneth E Bloom, DPMNPI 1811983372

Title

Owner

Phone

(704) 662-8336

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

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.

• Kenneth Evan Bloom, DPM

  • Foot & Ankle Surgery Podiatrist
  • Mooresville, NC
  • NPI 1811983372
  Authorized official Same address or phone
• Kurt Ashley Massey, DPM

  • Foot & Ankle Surgery Podiatrist
  • Mooresville, NC
  • NPI 1417943986
  NPD (past)

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274832000000",
    "number": "1538237474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 PROFESSIONAL PARK DR",
            "address_2": "SUITE C",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281176540",
            "telephone_number": "704-662-8336",
            "fax_number": "704-662-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 PROFESSIONAL PARK DR.",
            "address_2": "SUITE C",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "28117",
            "telephone_number": "704-662-8336",
            "fax_number": "704-662-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FOOT & ANKLE CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2010-05-26",
        "status": "A",
        "authorized_official_last_name": "BLOOM",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-662-8336",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NC",
            "license": "001752814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5905761",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Moriah Addison
• Ruth Damilola Adepetun, PMHNP-BC
• Joe K Ades, DPM
• Adm Physical Therapy, LLC (Ascend Physical Therapy)
• Advanced Athletic Training Solutions
• Advanced Health and Chiropractic Center, PLLC
• Advanced Healthcare
• Advanced Integrative Medicine
• Aesthetic Anesthesia PA (Rest Assured Aesthetic Anesthesia)
• Agmb Healthcare (The Senior Care Place)

• Podiatrist in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Podiatrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2010; 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.