Elite Foot and Ankle Specialist-PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

POD001084 Issued in GA

Legal business name

ELITE FOOT AND ANKLE SPECIALIST-PC

Practice address

1468 Springleaf Cir SE
Smyrna, GA 30080-2400

Phone

(678) 360-7939

NPI assigned

Apr 23, 2009

Last updated

Apr 23, 2009By 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

Grace Ivie Ejaife-Austin, DPMNPI 1588857304

Title

Podiatrist

Phone

(678) 360-7939

Specialties & licenses 1

Addresses

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.

• Grace Ivie Ejaife-Austin, DPM

  • Podiatrist
  • Greensboro, GA
  • NPI 1588857304
  NPD Authorized official

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240444800000",
    "number": "1750525515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1468 SPRINGLEAF CIR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300802400",
            "telephone_number": "678-360-7939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1468 SPRINGLEAF CIR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300802400",
            "telephone_number": "678-360-7939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE FOOT AND ANKLE SPECIALIST-PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-23",
        "last_updated": "2009-04-23",
        "status": "A",
        "authorized_official_last_name": "EJAIFE-AUSTIN",
        "authorized_official_first_name": "GRACE",
        "authorized_official_middle_name": "IVIE",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "678-360-7939",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD001084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Smyrna, GA
• Providers in Smyrna, 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 Apr 23, 2009; 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.