The Podiatry Care Center, LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

01318 Issued in MD

Legal business name

THE PODIATRY CARE CENTER, LLC

Practice address

12150 Annapolis Rd
Suite 109
Glenn Dale, MD 20769-9179

Phone

(301) 352-3668

Fax

(301) 352-3669

NPI assigned

Oct 15, 2007

Last updated

Aug 9, 2013By 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

Dr. Rhonda Lynn Nelson, D.P.M.NPI 1083603427

Title

Owner

Phone

(301) 352-3668

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

Enrollment records 2

Practitioners 3

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.

• Rhonda Nelson, DPM

  • Podiatrist
  • Glenn Dale, MD
  • NPI 1083603427

  DC

  Medicare reassignment NPD Authorized official
• Megha Patel

  • Podiatrist
  • Laurel, MD
  • NPI 1932305133

  DC

  Medicare reassignment NPD
• Dionne M. Storey-Crawford, DPM

  • Podiatrist
  • Bowie, MD
  • NPI 1316023625

  DC

  Medicare reassignment NPD

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376006400000",
    "number": "1548458664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12150 ANNAPOLIS RD",
            "address_2": "SUITE 109",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699179",
            "telephone_number": "301-352-3668",
            "fax_number": "301-352-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 ANNAPOLIS RD",
            "address_2": "SUITE 109",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699179",
            "telephone_number": "301-352-3668",
            "fax_number": "301-352-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PODIATRY CARE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2013-08-09",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "RHONDA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-352-3668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "01318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "86546",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS AND BLUESHIELD",
            "identifier": "J2590001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7294202",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI/MDIPA/OPT CHOICE",
            "identifier": "583402",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS AND BLUESHIELD",
            "identifier": "62204301",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "134103100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC PIN",
            "identifier": "5394560001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA - RAILROAD MEDICARE",
            "identifier": "DF6331",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Craig Michael Thomas, M.D.
• Barry Eugene Thompson, PA-C
• Nyeto Tiku
• Richson Mbah Tita
• Rita Tifuh Tita X, MD

• Podiatrist in Glenn Dale, MD
• Providers in Glenn Dale, MD by specialty
• Podiatrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.