Active NPI
Mark A Gotfryd, D.P.M.
- Podiatrist
- Birmingham, AL
National Provider Identifier
1780795781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 00109
- Practice address
- 1703 Center Point Pkwy
Birmingham, AL 35215-5505 - Phone
- (205) 853-7878
- Fax
- (205) 853-8272
- NPI assigned
- Aug 31, 2006
- Last updated
- Feb 7, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 00109 | AL | Primary |
Addresses
Primary practice location
1703 Center Point Pkwy
Birmingham, AL 35215-5505
Mailing address
1703 Center Point Pkwy
Birmingham, AL 35215-5505
Phone (205) 853-7878
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27-10029 | Other | AL | UHC PROVIDER NUMBER |
| 510-72959 | Other | AL | BC/BS OF ALABAMA PROVIDER |
| 510-71144 | Other | AL | BC/BS OF ALABAMA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00109 | AL | MD | Podiatrist |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Podiatrist
- Birmingham, AL
- NPI 1902972607
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1202342400000",
"number": "1780795781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1703 CENTER POINT PKWY",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352155505",
"telephone_number": "205-853-7878",
"fax_number": "205-853-8272"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1703 CENTER POINT PKWY",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352155505",
"telephone_number": "205-853-7878",
"fax_number": "205-853-8272"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTFRYD",
"first_name": "MARK",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2008-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "AL",
"license": "00109",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC PROVIDER NUMBER",
"identifier": "27-10029",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF ALABAMA PROVIDER",
"identifier": "510-72959",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF ALABAMA",
"identifier": "510-71144",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.