NPIMap

Organization Active NPI

Footsteps, LLC

  • Podiatrist
  • Baton Rouge, LA
National Provider Identifier
1700926409
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PD321R Issued in LA
Legal business name
FOOTSTEPS, LLC
Practice address
6141 Parkforest Dr
Baton Rouge, LA 70816-6111
Phone
(225) 756-0034
Fax
(225) 756-0708
NPI assigned
Feb 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Dr. Christopher Formanek, DPMNPI 1639146749
Title
Physician
Phone
(225) 756-0034

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X PD321R LA Primary

Addresses

Primary practice location

6141 Parkforest Dr
Baton Rouge, LA 70816-6111

Mailing address

6141 Parkforest Dr
Baton Rouge, LA 70816-6111
Phone (225) 756-0034

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050201000964 LA Part B Supplier - Clinic/Group Practice 6002867678 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
Practice locations: Gonzales, LA; Baton Rouge, LA
O20100930048995 LA DME Supplier - Physician - Podiatry 6002867678 Practice locations: Baton Rouge, LA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Footsteps LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6141 Parkforest Dr
Baton Rouge, LA 70816
Phone (225) 756-0034

711 W Cornerview St
Gonzales, LA 70737
Phone (225) 644-6581

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": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1700926409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6141 PARKFOREST DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166111",
            "telephone_number": "225-756-0034",
            "fax_number": "225-756-0708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6141 PARKFOREST DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166111",
            "telephone_number": "225-756-0034",
            "fax_number": "225-756-0708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTSTEPS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "FORMANEK",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "225-756-0034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "LA",
            "license": "PD321R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.