Organization Active NPI

Gadsden Foot Clinic, P.C.

  • Foot Surgery Podiatrist
  • Gadsden, AL
National Provider Identifier
1710043856
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
Legal business name
GADSDEN FOOT CLINIC, P.C.
Practice address
306 S 4TH St
Gadsden, AL 35901-5213
Phone
(256) 547-1631
Fax
(256) 547-1632
NPI assigned
Dec 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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

Authorized official

Name
Donna Chatham Waggoner
Title
Office Manager
Phone
(256) 547-1631

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X Primary

Addresses

Primary practice location

306 S 4TH St
Gadsden, AL 35901-5213

Mailing address

306 S 4TH St
Gadsden, AL 35901-5213
Phone (256) 547-1631

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051027001162 AL Part B Supplier - Clinic/Group Practice 8921025024 Receives reassigned benefits from 3 practitioners
Practice locations: Gadsden, AL
O20100930066553 AL DME Supplier - Physician - Podiatry 8921025024 Practice locations: Gadsden, AL

National Provider Directory

National Provider Directory

Locations

306 S 4th St
Gadsden, AL 35901
Phone (256) 546-4678

418 S 5th St
Gadsden, AL 35901
Phone (205) 543-1253

Practitioners & affiliated clinicians

Practitioners 5

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": "1167436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379462400000",
    "number": "1710043856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 S 4TH ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015213",
            "telephone_number": "256-547-1631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 S 4TH ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015213",
            "telephone_number": "256-547-1631",
            "fax_number": "256-547-1632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GADSDEN FOOT CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-30",
        "last_updated": "2013-09-18",
        "status": "A",
        "authorized_official_last_name": "WAGGONER",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "CHATHAM",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "256-547-1631"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.