Jack Andrew Harvey DPM, Inc.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E5204 Issued in CA

Legal business name

JACK ANDREW HARVEY DPM, INC.

Practice address

1210 E North St
Manteca, CA 95336-4962

Phone

(209) 823-2700

Fax

(209) 823-2779

NPI assigned

May 12, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jack Andrew Harvey, DPMNPI 1033475678

Title

President

Phone

(209) 823-2700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Jack Andrew Harvey, D.P.M

  • Foot & Ankle Surgery Podiatrist
  • Manteca, CA
  • NPI 1033475678
  Medicare reassignment NPD Authorized official
• Howard Charles Miller, DPM

  • Podiatrist
  • Manteca, CA
  • NPI 1295709285
  NPD (past)

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

{
    "created_epoch": "1431388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432166400000",
    "number": "1689052482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 E NORTH ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364962",
            "telephone_number": "209-823-2700",
            "fax_number": "209-823-2779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 E NORTH ST",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953364962",
            "telephone_number": "209-823-2700",
            "fax_number": "209-823-2779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK ANDREW HARVEY DPM, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-12",
        "last_updated": "2015-05-21",
        "status": "A",
        "authorized_official_last_name": "HARVEY",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "209-823-2700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Manteca, CA
• Providers in Manteca, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

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