Organization Active NPI

Saint Croix Podiatry LLC

  • Foot & Ankle Surgery Podiatrist
  • Christiansted, VI
National Provider Identifier
1689453722
Registry record updated Jan 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
SAINT CROIX PODIATRY LLC
Practice address
4000 Beeston Hill Medical Ctr Ste 9
Christiansted, VI 00820-5254
Phone
(540) 498-7301
NPI assigned
Sep 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2024

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

Authorized official

Name
John W Cook, DPMNPI 1619966579
Title
Owner
Phone
(340) 718-0030

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
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

4000 Beeston Hill Medical Ctr Ste 9
Christiansted, VI 00820-5254

Mailing address

4000 Beeston Hill Medical Ctr Ste 9
Christiansted, VI 00820-5254
Phone (340) 718-0030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20231122003213 VI Part B Supplier - Clinic/Group Practice 2062860448 Receives reassigned benefits from 1 practitioner
Practice locations: Christiansted, VI
O20250206002839 VI DME Supplier - Physician - Podiatry 2062860448 Practice locations: Christiansted, VI

National Provider Directory

National Provider Directory

Locations

4000 Beeston Hill Medical Ctr
Ste 9
Christiansted, VI 00820
Phone (340) 718-0030

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704758400000",
    "number": "1689453722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 BEESTON HILL MEDICAL CTR STE 9",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "008205254",
            "telephone_number": "340-718-0030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 BEESTON HILL MEDICAL CTR STE 9",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "008205254",
            "telephone_number": "540-498-7301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT CROIX PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-27",
        "last_updated": "2024-01-09",
        "certification_date": "2023-11-13",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "340-718-0030",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Christiansted, VI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.