Holly C Foote, DO, LLC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

25MB09608600 Issued in NJ

Legal business name

HOLLY C FOOTE, DO, LLC

Practice address

326 Edgewater Towne Ctr
Edgewater, NJ 07020-2222

Phone

(405) 795-8291

NPI assigned

Dec 9, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Holly Christine Foote, DO, MS

Title

President

Phone

(405) 795-8291

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418083200000",
    "number": "1669870507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 EDGEWATER TOWNE CTR",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070202222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 EDGEWATER TOWNE CTR",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070202222",
            "telephone_number": "405-795-8291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY C FOOTE, DO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-09",
        "last_updated": "2014-12-09",
        "status": "A",
        "authorized_official_last_name": "FOOTE",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "CHRISTINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-795-8291",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO, MS"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NJ",
            "license": "25MB09608600",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "NY",
            "license": "272882-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Edgewater, NJ
• Providers in Edgewater, NJ by specialty
• Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.