Organization Active NPI

Foot and Ankle Specialists of the Mid-Atlantic, LLC

  • Podiatrist
  • Mount Airy, MD
National Provider Identifier
1538660204
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
FOOT AND ANKLE SPECIALISTS OF THE MID-ATLANTIC, LLC
Practice address
1502 S Main St Ste 307
Mount Airy, MD 21771-5375
Phone
(301) 696-0818
NPI assigned
Feb 27, 2018
Organization subpart
Yes
Parent organization
FOOT AND ANKLE SPECIALISTS OF THE MID-ATLANTIC, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Authorized official

Name
David J Freedman
Title
Vice President
Phone
(301) 598-0130

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1502 S Main St Ste 307
Mount Airy, MD 21771-5375

Mailing address

PO Box 825159
Philadelphia, PA 19182-5159

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180607003295 MD DME Supplier - Physician - Podiatry 6305017633 Practice locations: Mount Airy, MD

National Provider Directory

National Provider Directory
Part of
Foot and Ankle Specialists of the Mid-Atlantic LLC

NPI Registry JSON

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

{
    "created_epoch": "1519689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1538660204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 825159",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191825159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 S MAIN ST STE 307",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217715375",
            "telephone_number": "301-696-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE SPECIALISTS OF THE MID-ATLANTIC, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOOT AND ANKLE SPECIALISTS OF THE MID-ATLANTIC, LLC",
        "enumeration_date": "2018-02-27",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A",
        "authorized_official_last_name": "FREEDMAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "301-598-0130"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; 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.