Individual provider Active NPI

Brad A. Lindstrom, DPM

  • Primary Podiatric Medicine Podiatrist
  • Mauldin, SC
National Provider Identifier
1609850122
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
555 Issued in SC
Practice address
211 E Butler Rd
Suite a-2
Mauldin, SC 29662-2169
Phone
(864) 281-9171
Fax
(864) 281-9170
NPI assigned
Nov 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 555 SC Primary

Addresses

Primary practice location

211 E Butler Rd
Suite a-2
Mauldin, SC 29662-2169

Mailing address

211 E Butler Rd
Suite a-2
Mauldin, SC 29662-2169
Phone (864) 281-9171

Other identifiers 1

IdentifierTypeStateIssuer
735550MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060119000099 SC Practitioner - Podiatry 4082507736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foot Clinic of South Carolina LLCGroup PAC ID 7315961349, 3 clinicians

Practice addresses (Care Compare)

211 E Butler Rd
Suite A2
Mauldin, SC 29662-2170
Phone (864) 281-9171

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue16
Removal of nail tissue2079
Removal or shaving of skin growth355
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
234ALMDProfessional Counselor
555SCMDPrimary Podiatric Medicine Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Foot Clinic of South Carolina, LLC CurrentSince Jan 1, 2005 Accepting new patients
Foot Clinic of South Carolina, LLC CurrentSince Jan 1, 2006 Accepting new patients
Paul D Brooks DPM PA Past Accepting new patients
Foot Clinic of South Carolina, LLC Past Accepting new patients
Jon a. Snellgrove DPM PA Past Accepting new patients

Locations

1035 Medical Ridge Rd
Clinton, SC 29325
Phone (864) 547-2089

998 Medical Ridge Rd
Clinton, SC 29325
Phone (864) 938-6984

211 E Butler Rd
#2
Mauldin, SC 29662

211 E Butler Rd
Ste A2
Mauldin, SC 29662
Phone (864) 281-9171

Interoperability endpoints

  • Direct secure messaging: blindstrom32250@direct.ghs.myhfn.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609850122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E BUTLER RD",
            "address_2": "SUITE A-2",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622169",
            "telephone_number": "864-281-9171",
            "fax_number": "864-281-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 E BUTLER RD",
            "address_2": "SUITE A-2",
            "city": "MAULDIN",
            "state": "SC",
            "postal_code": "296622169",
            "telephone_number": "864-281-9171",
            "fax_number": "864-281-9170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDSTROM",
        "first_name": "BRAD",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "SC",
            "license": "555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "735550",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mauldin, SC

Sources for this page

Verify at the official NPI Registry.