North Fulton Podiatry

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

00605 Issued in GA

Legal business name

NORTH FULTON PODIATRY

Practice address

1380 Upper Hembree Rd
Roswell, GA 30076-1146

Phone

(770) 346-7500

Fax

(770) 346-8800

NPI assigned

Dec 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Dean P Kostakos, DPMNPI 1417056847

Title

Owner

Phone

(770) 346-7500

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA2 enrollments

Enrollment records 2

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGDFBA

Practitioners 1

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

• Dean P Kostakos, D.P.M.

  • Podiatrist
  • Roswell, GA
  • NPI 1417056847
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198195200000",
    "number": "1720260409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 UPPER HEMBREE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761146",
            "telephone_number": "770-346-7500",
            "fax_number": "770-346-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 UPPER HEMBREE RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761146",
            "telephone_number": "770-346-7500",
            "fax_number": "770-346-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FULTON PODIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2007-12-21",
        "status": "A",
        "authorized_official_last_name": "KOSTAKOS",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-346-7500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "00605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC3957",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "5271380001",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North Fulton Hospitalist Group, LLC
• North Fulton Imaging Partners, LP
• North Fulton Internal Medicine Group
• North Fulton Opical Inc.
• North Fulton Pediatrics
• North Fulton Primary Care-Willeo Road, LLC
• North Fulton Psychiatric Care PC
• North Fulton Pulmonary Specialists, LLC
• North Fulton Regional
• North Fulton Regional Medical Center Pro Fee Billing, LLC

• Foot & Ankle Surgery Podiatrist in Roswell, GA
• Providers in Roswell, 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 Dec 21, 2007; 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.