Organization Active NPI

The Foot and Ankle Treatment Center LLC

  • Surgery Physician
  • Watkinsville, GA
National Provider Identifier
1740750041
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
THE FOOT AND ANKLE TREATMENT CENTER LLC
Practice address
2410 Hog Mountain Rd Ste 107
Watkinsville, GA 30677-4850
Phone
(706) 310-4288
Fax
(855) 312-5251
NPI assigned
Nov 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Authorized official

Name
Dr. Donovan Audley Gowdie, DPMNPI 1770749822
Title
Provider
Phone
(706) 310-4288

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
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

2410 Hog Mountain Rd Ste 107
Watkinsville, GA 30677-4850

Mailing address

2410 Hog Mountain Rd Ste 107
Watkinsville, GA 30677-4850
Phone (706) 310-4288

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190322001567 GA Part B Supplier - Clinic/Group Practice 2466792726 Receives reassigned benefits from 1 practitioner
Practice locations: Watkinsville, GA
O20210125002477 GA DME Supplier - Physician - General Practice 2466792726 Practice locations: Watkinsville, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543449600000",
    "number": "1740750041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 HOG MOUNTAIN RD STE 107",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306774850",
            "telephone_number": "706-310-4288",
            "fax_number": "855-312-5251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 HOG MOUNTAIN RD STE 107",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306774850",
            "telephone_number": "706-310-4288",
            "fax_number": "855-312-5251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FOOT AND ANKLE TREATMENT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-11-29",
        "status": "A",
        "authorized_official_last_name": "GOWDIE",
        "authorized_official_first_name": "DONOVAN",
        "authorized_official_middle_name": "AUDLEY",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "706-310-4288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.