Organization Active NPI

Lansdowne Podiatry

  • Foot & Ankle Surgery Podiatrist
  • Leesburg, VA
National Provider Identifier
1659741742
Registry record updated Dec 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
LANSDOWNE PODIATRY
Practice address
44135 Woodridge Pkwy
Suite 180
Leesburg, VA 20176-1244
Phone
(571) 223-0424
Fax
(571) 223-0425
NPI assigned
Oct 1, 2015
Last updated
Dec 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2015

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

Authorized official

Name
Monique Renee Rolle, D.P.M.
Title
Owner
Phone
(571) 223-0424

Specialties & licenses 1

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

Addresses

Primary practice location

44135 Woodridge Pkwy
Suite 180
Leesburg, VA 20176-1244

Mailing address

10845 Philadelphia Rd
White Marsh, MD 21162-1717
Phone (410) 335-0008

Other identifiers 2

IdentifierTypeStateIssuer
F094OtherVAMEDICARE
1659741742OtherVAMEDICAL ASSISTANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20151105002114 VA Part B Supplier - Clinic/Group Practice 1456661305 Receives reassigned benefits from 1 practitioner
Practice locations: Leesburg, VA
O20170914000971 DC Part B Supplier - Clinic/Group Practice 1456661305 Receives reassigned benefits from 1 practitioner
Practice locations: Washington, DC

National Provider Directory

National Provider Directory

Locations

3901 Georgia Ave NW
Ste 2
Washington, DC 20011
Phone (202) 543-0035

Practitioners & affiliated clinicians

Practitioners 1

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": "1443657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450396800000",
    "number": "1659741742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10845 PHILADELPHIA RD",
            "city": "WHITE MARSH",
            "state": "MD",
            "postal_code": "211621717",
            "telephone_number": "410-335-0008",
            "fax_number": "410-335-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44135 WOODRIDGE PKWY",
            "address_2": "SUITE 180",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201761244",
            "telephone_number": "571-223-0424",
            "fax_number": "571-223-0425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LANSDOWNE PODIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-01",
        "last_updated": "2015-12-18",
        "status": "A",
        "authorized_official_last_name": "ROLLE",
        "authorized_official_first_name": "MONIQUE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-223-0424",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "F094",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "1659741742",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.