Valdosta Foot & Ankle Clinic, P.C.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

VALDOSTA FOOT & ANKLE CLINIC, P.C.

Practice address

2800 N Oak St
Valdosta, GA 31602-1716

Phone

(229) 244-1211

Fax

(229) 244-2721

NPI assigned

Jul 20, 2007

Last updated

Sep 18, 2013By 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

Dr. Michael R. Wallace, D.P.M.NPI 1295828416

Title

Owner

Phone

(229) 244-1211

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Michael Robert Wallace, DPM

  • Foot & Ankle Surgery Podiatrist
  • Valdosta, GA
  • NPI 1295828416
  Medicare reassignment Care Compare group NPD Authorized official
• Devin Lee Daugherty, DPM

  • Foot & Ankle Surgery Podiatrist
  • Valdosta, GA
  • NPI 1780777904
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379462400000",
    "number": "1699975375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 N OAK ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021716",
            "telephone_number": "229-244-1211",
            "fax_number": "229-244-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 N OAK ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021716",
            "telephone_number": "229-244-1211",
            "fax_number": "229-244-2721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALDOSTA FOOT & ANKLE CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2013-09-18",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "229-244-1211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valdosta City Board of Education
• Valdosta Dental Associates
• Valdosta Endoscopy Center, LLC
• Valdosta Family Dentistry
• Valdosta Family Medicine Associates, P.C. (Valdosta Family Medicine)
• Valdosta Foot & Ankle Surgery Center, P.C.
• Valdosta Gastroenterology Associates, LLC
• Valdosta Health & Wellness Clinic Inc
• Valdosta Healthcare Club
• Valdosta Imaging Center Inc

• Foot & Ankle Surgery Podiatrist in Valdosta, GA
• Providers in Valdosta, 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 Sep 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.