Organization Active NPI

Foot & Ankle Associates of North Carolina, PLLC

  • Clinical Medical Laboratory
  • Raleigh, NC
National Provider Identifier
1659543833
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
FOOT & ANKLE ASSOCIATES OF NORTH CAROLINA, PLLC
Practice address
2701 New Bern Ave
Raleigh, NC 27610-1822
Phone
(919) 231-7969
Fax
(919) 231-7970
NPI assigned
Mar 28, 2008
Last updated
Jan 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Authorized official

Name
Dr. Clarence Stewart, DPMNPI 1669458915
Title
Partner
Phone
(919) 231-7969

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary
Podiatrist 213E00000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU

Addresses

Primary practice location

2701 New Bern Ave
Raleigh, NC 27610-1822

Mailing address

PO Box 14759
Raleigh, NC 27620-4759
Phone (919) 231-7969

Other identifiers 3

IdentifierTypeStateIssuer
690187EMedicaidNC
0809WOtherNCBCBS GROUP
CK8360OtherNCPALMETTO GBA RAILROAD ME

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220525000582 NC Part B Supplier - Independent Clinical Laboratory 2365497385 1 other NPI on this enrollment
Practice locations: Raleigh, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2250012Foot and Ankle Associates of NC, PLC, the2701 New Bern Avenue, Raleigh, NC 27610AccreditationJan 23, 2027

National Provider Directory

National Provider Directory

Locations

320 Veterans Pkwy
Clayton, NC 27520
Phone (919) 763-1510

2701 New Bern Ave
Raleigh, NC 27610
Phone (919) 231-7969

1406 Western Blvd
Ste A
Tarboro, NC 27886
Phone (252) 824-7700

2130 Forest Hills Rd W
Ste C
Wilson, NC 27893
Phone (252) 281-4442

Practitioners & affiliated clinicians

Practitioners 8

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": "1206662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1659543833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14759",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276204759",
            "telephone_number": "919-231-7969",
            "fax_number": "919-231-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101822",
            "telephone_number": "919-231-7969",
            "fax_number": "919-231-7970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE ASSOCIATES OF NORTH CAROLINA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-28",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "919-231-7969",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690187E",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "0809W",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA RAILROAD ME",
            "identifier": "CK8360",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.