Organization Active NPI

Comprehensive Foot & Ankle

  • Podiatric Clinic/Center
  • Lilburn, GA
National Provider Identifier
1780871251
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
License
POD000918 Issued in GA
Legal business name
COMPREHENSIVE FOOT & ANKLE
Practice address
4705 Lawrenceville Hwy NW
Suite C
Lilburn, GA 30047-3667
Phone
(770) 921-8800
Fax
(770) 921-8801
NPI assigned
Sep 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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

Authorized official

Name
Dr. James Palmer Branch, DPMNPI 1346244985
Title
Owner
Phone
(770) 921-8800

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
Podiatric Clinic/Center 261QP1100X POD000918 GA Primary

Addresses

Primary practice location

4705 Lawrenceville Hwy NW
Suite C
Lilburn, GA 30047-3667

Mailing address

4705 Lawrenceville Highway
Suite C
Lilburn, GA 30047
Phone (770) 921-8800

Other identifiers 1

IdentifierTypeStateIssuer
000930069KMedicaidGA

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20071231000009 GA Part B Supplier - Clinic/Group Practice 3870673080 Receives reassigned benefits from 1 practitioner
Practice locations: Cumming, GA; Lilburn, GA
O20100930096141 GA DME Supplier - Physician - Podiatry 3870673080 1 other NPI on this enrollment
Practice locations: Lilburn, GA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Comprehensive Foot Ankle LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

600 Peachtree Pkwy
Ste 115
Cumming, GA 30041
Phone (770) 886-6833

6630 McGinnis Ferry Rd
Ste C
Johns Creek, GA 30097
Phone (770) 476-7229

4705 Lawrenceville Hwy NW
Ste C
Lilburn, GA 30047
Phone (770) 921-8800

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190937600000",
    "number": "1780871251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 LAWRENCEVILLE HIGHWAY",
            "address_2": "SUITE C",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "30047",
            "telephone_number": "770-921-8800",
            "fax_number": "770-921-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 LAWRENCEVILLE HWY NW",
            "address_2": "SUITE C",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300473667",
            "telephone_number": "770-921-8800",
            "fax_number": "770-921-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE FOOT & ANKLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2007-09-28",
        "status": "A",
        "authorized_official_last_name": "BRANCH",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "PALMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-921-8800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "GA",
            "license": "POD000918",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000930069K",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; 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.