Organization Active NPI

Greater Salem Family Footcare Associates PC

  • Podiatrist
  • Salem, NH
National Provider Identifier
1669542239
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
GREATER SALEM FAMILY FOOTCARE ASSOCIATES PC
Practice address
198 Main St
Salem, NH 03079-3113
Phone
(603) 898-5864
Fax
(603) 898-1207
NPI assigned
Nov 9, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Stanley A Gorgol, DPMNPI 1619047289
Title
Office MGR
Phone
(603) 898-5864

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X NH Primary

Addresses

Primary practice location

198 Main St
Salem, NH 03079-3113

Mailing address

198 Main St
Greater Salem Family Footcare Associates PC
Salem, NH 03079
Phone (603) 898-5864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050114000189 NH Part B Supplier - Clinic/Group Practice 5597714790 Receives reassigned benefits from 1 practitioner
Practice locations: Salem, NH
O20100930010596 NH DME Supplier - Physician - Podiatry 5597714790 Practice locations: Salem, NH

National Provider Directory

National Provider Directory

Locations

49 Birch St
Derry, NH 03038
Phone (603) 434-8790

198 Main St
Salem, NH 03079
Phone (603) 898-5864

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/c3T6PEIfPZoUF9gf3uvco_NB4kf7fIWo/

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": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1669542239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 MAIN ST",
            "address_2": "GREATER SALEM FAMILY FOOTCARE ASSOCIATES PC",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "03079",
            "telephone_number": "603-898-5864",
            "fax_number": "603-898-1207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 MAIN ST",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030793113",
            "telephone_number": "603-898-5864",
            "fax_number": "603-898-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER SALEM FAMILY FOOTCARE ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GORGOL",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MGR",
        "authorized_official_telephone_number": "603-898-5864",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.