George S Tellam DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

PO 1636 Issued in FL

Legal business name

GEORGE S TELLAM DPM

Practice address

2710 3Rd St S
Jacksonville Beach, FL 32250-6028

Phone

(904) 269-9595

Fax

(904) 264-5211

NPI assigned

Oct 14, 2015

Organization subpart

No

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

Authorized official

Name

Shelley Sawday Thomas, DPM

Title

Owner/Podiatrist

Phone

(904) 269-9595

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ankle & Foot Associates Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

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

• George Sawday Tellam, DPM

  • Foot & Ankle Surgery Podiatrist
  • Orange Park, FL
  • NPI 1750319026
  NPD

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1669843751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320734742",
            "telephone_number": "904-269-9595",
            "fax_number": "904-264-5211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 3RD ST S",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322506028",
            "telephone_number": "904-269-9595",
            "fax_number": "904-264-5211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE S TELLAM DPM",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-14",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "SAWDAY",
        "authorized_official_title_or_position": "OWNER/PODIATRIST",
        "authorized_official_telephone_number": "904-269-9595",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO 1636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1750319026",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "doctortellam@gt.ssdirect.aprima.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2710 3rd St S",
            "city": "Jacksonville Beach",
            "state": "FL",
            "country_code": "US",
            "postal_code": "322506028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Ankle & Foot Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ankle & Foot Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nanette Jolie Gauthier, MCD, CCC-SLP
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• Gentle Dentists Beaches, LLC
• George M Joseph MD PA
• Joe E Gerges El Khoury, M.D.
• Deborah Lane Ghandour, PA-C, DHSC
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• Samuel Giles

• Podiatrist in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Podiatrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.