NPIMap

Organization Active NPI

Carey a. Bledsoe, D.P.M., a Professional Medical Corporation

  • Foot & Ankle Surgery Podiatrist
  • Upland, CA
National Provider Identifier
1639448244
Registry record updated Dec 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
CAREY A. BLEDSOE, D.P.M., A PROFESSIONAL MEDICAL CORPORATION
Practice address
901 San Bernardino Rd
Suite 104
Upland, CA 91786-4912
Phone
(909) 946-6643
Fax
(909) 946-6130
NPI assigned
Dec 28, 2011
Last updated
Dec 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2011

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

Authorized official

Name
Dr. Carey A Bledsoe, DPM, MS, FACFASNPI 1558352971
Title
President/Chief Executive Officer
Phone
(909) 946-6643

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 Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

901 San Bernardino Rd
Suite 104
Upland, CA 91786-4912

Mailing address

901 San Bernardino Rd
Suite 104
Upland, CA 91786-4912
Phone (909) 946-6643

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1325030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325030400000",
    "number": "1639448244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 SAN BERNARDINO RD",
            "address_2": "SUITE 104",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864912",
            "telephone_number": "909-946-6643",
            "fax_number": "909-946-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 SAN BERNARDINO RD",
            "address_2": "SUITE 104",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917864912",
            "telephone_number": "909-946-6643",
            "fax_number": "909-946-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAREY A. BLEDSOE, D.P.M., A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-28",
        "last_updated": "2011-12-28",
        "status": "A",
        "authorized_official_last_name": "BLEDSOE",
        "authorized_official_first_name": "CAREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "909-946-6643",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM, MS, FACFAS"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2011; 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.