NPIMap

Organization Active NPI

Indian River Podiatry, PA

  • Foot & Ankle Surgery Podiatrist
  • Sebastian, FL
National Provider Identifier
1609408996
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
INDIAN RIVER PODIATRY, PA
Practice address
1515 US Highway 1 Ste 204
Sebastian, FL 32958-1612
Phone
(772) 569-0081
NPI assigned
Feb 5, 2020
Organization subpart
Yes
Parent organization
INDIAN RIVER PODIATRY, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
Nicholas Ward RutledgeNPI 1669495172
Title
Owner
Phone
(772) 569-0081

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
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

1515 US Highway 1 Ste 204
Sebastian, FL 32958-1612

Mailing address

PO Box 99
Vero Beach, FL 32961-0099
Phone (772) 569-0081

National Provider Directory

National Provider Directory
Tax ID family
Indian River Podiatry2 organizations share this tax ID, including this one
Part of
Indian River Podiatry

Other organizations with this tax ID 1

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

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 2

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": "1580860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1609408996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "VERO BEACH",
            "state": "FL",
            "postal_code": "329610099",
            "telephone_number": "772-569-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 US HIGHWAY 1 STE 204",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329581612",
            "telephone_number": "772-569-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER PODIATRY, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "INDIAN RIVER PODIATRY, PA",
        "enumeration_date": "2020-02-05",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "RUTLEDGE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "WARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-569-0081"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.