Foot and Leg Clinic, PA

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

FOOT AND LEG CLINIC, PA

Doing business as

Ambulatory Foot and Leg Surgical Center

Practice address

1650 Mulkey Rd
Austell, GA 30106-1186

Phone

(770) 544-0444

Fax

(770) 874-8950

NPI assigned

Mar 21, 2007

Last updated

Aug 13, 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

Ms. Jana S. Taylor

Title

Credentialing Manager

Phone

(770) 544-0444

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• AMBULATORY FOOT AND LEG SURGICAL CENTER Doing business as

Locations

Practitioners 1

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.

• Brett Fried, DPM

  • Foot & Ankle Surgery Podiatrist
  • Royal Palm Beach, FL
  • NPI 1932167335
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1740306059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1652 MULKEY RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "30106",
            "telephone_number": "770-544-0444",
            "fax_number": "770-874-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 MULKEY RD",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061186",
            "telephone_number": "770-544-0444",
            "fax_number": "770-874-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND LEG CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JANA",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "770-544-0444",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0042221A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMBULATORY FOOT AND LEG SURGICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brian Richard Flannery I, D.C.
• Hector Rafael Flores-Bermudez, M.D.
• Niquetta Adell Flowers, LPC
• Comfort Fokuo-Ameyaw
• Ivy Folds, MLT, ASCP
• Foot and Leg Clinic, PC
• Kelsey Irene Fortier, NP-C
• Fortified Home Healthcare
• Fortitude Matters Consulting
• Tracey M Fortner, FNP-BC

• Ambulatory Surgical Clinic/Center in Austell, GA
• Providers in Austell, GA by specialty
• Ambulatory Surgical Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.