NPIMap

Organization Active NPI

1Foot 2Foot Centre for Foot and Ankle Care, PC

  • Durable Medical Equipment & Medical Supplies
  • Hampton, VA
National Provider Identifier
1588023030
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0103300887 Issued in VA
Legal business name
1FOOT 2FOOT CENTRE FOR FOOT AND ANKLE CARE, PC
Practice address
2240 Coliseum Dr Ste a
Hampton, VA 23666-5903
Phone
(579) 340-7687
Fax
(757) 925-1901
NPI assigned
Feb 12, 2016
Last updated
Feb 28, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
1FOOT 2FOOT CENTRE FOR FOOT AND ANKLE CARE, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Authorized official

Name
Matthew C DairmanNPI 1144226853
Title
Owner
Phone
(757) 934-0768

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
Durable Medical Equipment & Medical Supplies 332B00000X 0103300887 VA Primary

Addresses

Primary practice location

2240 Coliseum Dr Ste a
Hampton, VA 23666-5903

Mailing address

171 N Main St
Suffolk, VA 23434-4507
Phone (757) 934-0768

Other identifiers 1

IdentifierTypeStateIssuer
010316057MedicaidVA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161012002066 VA DME Supplier - Physician - Podiatry 7315042835 Practice locations: Hampton, VA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
1Foot 2Foot Centre for Foot3 organizations share this tax ID, including this one
Part of
1Foot 2Foot Centre for Foot

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

171 N Main St
Suffolk, VA 23434
Phone (757) 934-0768

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1646006400000",
    "number": "1588023030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 N MAIN ST",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234344507",
            "telephone_number": "757-934-0768",
            "fax_number": "757-925-1901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 COLISEUM DR STE A",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236665903",
            "telephone_number": "579-340-7687",
            "fax_number": "757-925-1901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1FOOT 2FOOT CENTRE FOR FOOT AND ANKLE CARE, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "1FOOT 2FOOT CENTRE FOR FOOT AND ANKLE CARE, PC",
        "enumeration_date": "2016-02-12",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A",
        "authorized_official_last_name": "DAIRMAN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-934-0768"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": "0103300887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010316057",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.