Organization Active NPI

Community Podiatry & Wound Care PA

  • Foot & Ankle Surgery Podiatrist
  • St Augustine, FL
National Provider Identifier
1730354523
Registry record updated Jan 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO2734 Issued in FL
Legal business name
COMMUNITY PODIATRY & WOUND CARE PA
Practice address
6 Saint Johns Medical Park Dr
St Augustine, FL 32086-4233
Phone
(904) 823-3301
Fax
(904) 823-3328
NPI assigned
Apr 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2012

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

Authorized official

Name
Rosana Rodriguez, DPM
Title
Doctor
Phone
(904) 823-3301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO2734 FL Primary

Addresses

Primary practice location

6 Saint Johns Medical Park Dr
St Augustine, FL 32086-4233

Mailing address

1960 US Highway 1 South
PMB 510
St Augustine, FL 32086-4233
Phone (904) 823-3301

National Provider Directory

National Provider Directory

Locations

1960 US Highway 1 S
Saint Augustine, FL 32086

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": "1208908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326758400000",
    "number": "1730354523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1960 US HIGHWAY 1 SOUTH",
            "address_2": "PMB 510",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864233",
            "telephone_number": "904-823-3301",
            "fax_number": "904-823-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 SAINT JOHNS MEDICAL PARK DR",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320864233",
            "telephone_number": "904-823-3301",
            "fax_number": "904-823-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PODIATRY & WOUND CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-23",
        "last_updated": "2012-01-17",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "ROSANA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "904-823-3301",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO2734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.