Foot Ankle & Wound Care Center Corp

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO3624 Issued in FL

Legal business name

FOOT ANKLE & WOUND CARE CENTER CORP

Practice address

2262 Dunn Ave
Suite #3
Jacksonville, FL 32218-4720

Phone

(904) 666-5170

NPI assigned

Mar 23, 2016

Last updated

Nov 17, 2016By 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

Ms. Diandra K Gordon, DPM

Title

Owner/Ceo

Phone

(904) 666-5170

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1458691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479340800000",
    "number": "1598127151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2262 DUNN AVE",
            "address_2": "SUITE #3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184720",
            "telephone_number": "904-666-5170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2262 DUNN AVE",
            "address_2": "SUITE #3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184720",
            "telephone_number": "904-666-5170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT ANKLE & WOUND CARE CENTER CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-23",
        "last_updated": "2016-11-17",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "DIANDRA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "904-666-5170",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3624",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "FL",
            "license": "PO3308",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010198600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Marie Font Diaz, MD
• Cristina Michelle Font, MD
• Emily Fontane, MD
• Tabetha Foose, RD, LD/N
• Foot & Ankle Specialists of Jacksonville, Inc.
• Foot Clinic-Dr. S.F. Wernow
• Foot Services by Jaynell M Smith-Cameron
• Lauren Lynne Foote, CCC-SLP
• James Foran, MD
• Wendi Forbes, L.C.S.W.

• Foot & Ankle Surgery Podiatrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Foot & Ankle Surgery Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2016; 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.