Organization Active NPI

Eric S Trathen DPM Inc

  • Foot & Ankle Surgery Podiatrist
  • Fort Myers, FL
National Provider Identifier
1649664426
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO3472 Issued in FL
Legal business name
ERIC S TRATHEN DPM INC
Practice address
12630 World Plaza LN
70
Fort Myers, FL 33907-3987
Phone
(239) 689-1235
Fax
(239) 274-8319
NPI assigned
Mar 19, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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

Authorized official

Name
Dr. Eric Stephen Trathen, DPMNPI 1093963449
Title
Physician/President
Phone
(239) 689-1235

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 PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO3472 FL Primary

Addresses

Primary practice location

12630 World Plaza LN
70
Fort Myers, FL 33907-3987

Mailing address

12630 World Plaza LN
70
Fort Myers, FL 33907-3987
Phone (239) 689-1235

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241025000437 FL DME Supplier - Physician - Podiatry 4688107923 Practice locations: Fort Myers, FL

National Provider Directory

National Provider Directory

Locations

12630 World Plaza Ln
#70
Fort Myers, FL 33907
Phone (239) 936-3344

12630 World Plaza Ln
Ste 70
Fort Myers, FL 33907
Phone (239) 689-1235

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426723200000",
    "number": "1649664426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12630 WORLD PLAZA LN",
            "address_2": "70",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073987",
            "telephone_number": "239-689-1235",
            "fax_number": "239-274-8319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12630 WORLD PLAZA LN",
            "address_2": "70",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073987",
            "telephone_number": "239-689-1235",
            "fax_number": "239-274-8319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC S TRATHEN DPM INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-19",
        "last_updated": "2015-03-19",
        "status": "A",
        "authorized_official_last_name": "TRATHEN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "239-689-1235",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; 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.