Achilles Foot & Ankle Specialist

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

POD000585 Issued in GA

Legal business name

ACHILLES FOOT & ANKLE SPECIALIST

Practice address

1580 Mars Hill Rd
Suite a
Watkinsville, GA 30677-4836

Phone

(706) 769-9200

NPI assigned

Aug 29, 2007

Last updated

Mar 19, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark William Shaffer, DPMNPI 1023015146

Title

Owner/Physician

Phone

(706) 769-9200

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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.

• Mark William Shaffer, DPM

  • Foot & Ankle Surgery Podiatrist
  • Monroe, GA
  • NPI 1023015146
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205884800000",
    "number": "1689868085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 463",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306770012",
            "telephone_number": "706-769-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 MARS HILL RD",
            "address_2": "SUITE A",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306774836",
            "telephone_number": "706-769-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACHILLES FOOT & ANKLE SPECIALIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2008-03-19",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "706-769-9200",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD000585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "GRP 2505",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Watkinsville, GA
• Providers in Watkinsville, GA by specialty
• Foot & Ankle Surgery Podiatrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2008; 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.