Southern Delaware Foot & Ankle LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E1-0000121 Issued in DE

Legal business name

SOUTHERN DELAWARE FOOT & ANKLE LLC

Practice address

543 N Shipley St
Suite C
Seaford, DE 19973-2339

Phone

(302) 629-3000

Fax

(302) 629-3080

NPI assigned

Feb 9, 2007

Organization subpart

No

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

Authorized official

Name

Bradley T Lemon, DPMNPI 1366448730

Title

Owner

Phone

(302) 629-3000

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in DE2 enrollments

Enrollment records 2

Locations

Practitioners 5

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

• Bradley T Lemon, D.P.M, F.A.C.F.S

  • Foot & Ankle Surgery Podiatrist
  • Seaford, DE
  • NPI 1366448730
  Medicare reassignment Care Compare group NPD Authorized official
• Christopher M. Heisey, D.P.M

  • Primary Podiatric Medicine Podiatrist
  • Seaford, DE
  • NPI 1497126981
  Medicare reassignment Care Compare group NPD
• Allen Mirzaei, DPM

  • Primary Podiatric Medicine Podiatrist
  • Seaford, DE
  • NPI 1164859336
  Medicare reassignment Care Compare group NPD
• Roman C Orsini, DPM

  • Foot & Ankle Surgery Podiatrist
  • Lewes, DE
  • NPI 1184721664
  NPD (past)
• James F Palmer, DPM

  • Podiatrist
  • Seaford, DE
  • NPI 1740391747
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303776000000",
    "number": "1548301005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199730772",
            "telephone_number": "302-629-3613",
            "fax_number": "302-629-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "543 N SHIPLEY ST",
            "address_2": "SUITE C",
            "city": "SEAFORD",
            "state": "DE",
            "postal_code": "199732339",
            "telephone_number": "302-629-3000",
            "fax_number": "302-629-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DELAWARE FOOT & ANKLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2011-04-26",
        "status": "A",
        "authorized_official_last_name": "LEMON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-629-3000",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "DE",
            "license": "E1-0000121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8699345001",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM CHOICE",
            "identifier": "448142",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00062710",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2220599000",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - PPO",
            "identifier": "3314440",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000025919",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "2161",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - HMO",
            "identifier": "3316680",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "510401832",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elaine Smith
• Marcie Lynn Smith, PTA
• Nicole Smith
• Renee W Smith, MSW
• Priscilla Songate, APRN
• Southern Delaware Sports Care and Rehabilitation, LLC
• Southern Dental LLC
• Christina Kay Spanos, RN
• Susan S Spause, F.N.P.
• State of Delaware

• Foot & Ankle Surgery Podiatrist in Seaford, DE
• Providers in Seaford, DE by specialty
• Foot & Ankle Surgery Podiatrist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2011; 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.