Organization Active NPI

Feet First Podiatry, LLC

  • Foot & Ankle Surgery Podiatrist
  • Macon, GA
National Provider Identifier
1649648569
Registry record updated Aug 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD000981 Issued in GA
Legal business name
FEET FIRST PODIATRY, LLC
Practice address
440 Charter Blvd Ste 2202
Macon, GA 31210-0705
Phone
(478) 741-4332
Fax
(478) 741-4343
NPI assigned
Sep 9, 2015
Last updated
Aug 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2020

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

Authorized official

Name
Dr. Consuela M Williams-Holliday, DPMNPI 1780602011
Title
Physician
Phone
(478) 741-4332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X POD000981 GA Primary

Addresses

Primary practice location

440 Charter Blvd Ste 2202
Macon, GA 31210-0705

Mailing address

PO Box 4124
Macon, GA 31208-4124
Phone (478) 741-4332

Other practice location 1

2660 Montpelier Ave
Macon, GA 31204-5226
Phone (478) 741-4332

Other identifiers 1

IdentifierTypeStateIssuer
436532810BMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190318000578 GA Part B Supplier - Clinic/Group Practice 2062752728 Receives reassigned benefits from 1 practitioner
Practice locations: Macon, GA

National Provider Directory

National Provider Directory

Locations

1765 Shurling Dr
Macon, GA 31211
Phone (478) 741-4332

440 Charter Blvd
Ste 2202
Macon, GA 31210
Phone (478) 741-4332

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": "1441756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597622400000",
    "number": "1649648569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4124",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312084124",
            "telephone_number": "478-741-4332",
            "fax_number": "478-741-4343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 CHARTER BLVD STE 2202",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312100705",
            "telephone_number": "478-741-4332",
            "fax_number": "478-741-4343"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2660 Montpelier Ave",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312045226",
            "country_code": "US",
            "telephone_number": "478-741-4332",
            "fax_number": "478-741-4343",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FEET FIRST PODIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-09",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS-HOLLIDAY",
        "authorized_official_first_name": "CONSUELA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "478-741-4332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD000981",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "436532810B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.