Lodi Podiatry Group

Primary specialty

PodiatristTaxonomy code 213E00000X

License

E3467 Issued in CA

Legal business name

LODI PODIATRY GROUP

Practice address

1300 W Lodi Ave
Ste W
Lodi, CA 95242-3038

Phone

(209) 334-6664

Fax

(209) 334-2379

NPI assigned

Jan 10, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Kerry Lyn Myers

Title

Office Manager

Phone

(209) 334-0429

Specialties & licenses 6

Addresses

Other identifiers 2

Other names 1

• SHOCK THOMAS GEN PTR Other name

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Locations

Practitioners 3

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

• Andy Archuleta, DPM

  • Foot & Ankle Surgery Podiatrist
  • Lodi, CA
  • NPI 1407417744
  Medicare reassignment Care Compare group NPD
• Alexander J Curfman, DPM

  • Foot & Ankle Surgery Podiatrist
  • Lodi, CA
  • NPI 1316327240
  Medicare reassignment Care Compare group NPD
• Kevin Irving Stroh, DPM

  • Podiatrist
  • Lodi, CA
  • NPI 1104829431
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1136851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447286400000",
    "number": "1750360699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W LODI AVE",
            "address_2": "STE W",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423038",
            "telephone_number": "209-334-6664",
            "fax_number": "209-334-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W LODI AVE",
            "address_2": "STE W",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423038",
            "telephone_number": "209-334-6664",
            "fax_number": "209-334-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LODI PODIATRY GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-10",
        "last_updated": "2015-11-12",
        "status": "A",
        "authorized_official_last_name": "MYERS",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "209-334-0429",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3241",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3467",
            "primary": true
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Radiology",
            "state": "CA",
            "license": "E3241",
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Radiology",
            "state": "CA",
            "license": "E3467",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3241",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3467",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E32410",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E34670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHOCK THOMAS GEN PTR",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lodi Orthopaedic Medical Group
• Lodi Pain Clinic, Inc.
• Lodi Pharmacy Inc
• Lodi Pharmacy LLC
• Lodi Plaza Head & Neck Medical Assoc Inc
• Lodi Sick Room Supply Inc
• Lodi Skilled Nursing Services, Inc.
• Lodi Sleep Disorders Management Group LP
• Lodi Unified School District
• Lodi Urological Medical Group, Inc.

• Podiatrist in Lodi, CA
• Providers in Lodi, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2015; 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.