T Joe Wongananda DPM PA

Primary specialty

PodiatristTaxonomy code 213E00000X

License

01281 Issued in MD

Legal business name

T JOE WONGANANDA DPM PA

Practice address

806 Landmark Dr
Ste 128 - 129
Glen Burnie, MD 21061-4966

Phone

(443) 926-9147

Fax

(443) 926-9151

NPI assigned

Jun 4, 2007

Last updated

May 5, 2011By 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

Dr. Taan Joe Wongananda, DPM

Title

Director

Phone

(443) 926-9147

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD2 enrollments

Enrollment records 2

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.

• T. Joe Wongananda

  • Podiatrist
  • Glen Burnie, MD
  • NPI 1982786844
  Medicare reassignment NPD

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304553600000",
    "number": "1780886549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "806 LANDMARK DR",
            "address_2": "STE 128 - 129",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614966",
            "telephone_number": "443-926-9147",
            "fax_number": "443-926-9151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 LANDMARK DR",
            "address_2": "STE 128 - 129",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614966",
            "telephone_number": "443-926-9147",
            "fax_number": "443-926-9151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T JOE WONGANANDA DPM PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2011-05-05",
        "status": "A",
        "authorized_official_last_name": "WONGANANDA",
        "authorized_official_first_name": "TAAN",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "443-926-9147",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "01281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MY INDIVIDUAL NPI",
            "identifier": "1982786844",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "166603700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheryl Kay Swidensky, LCSW-C
• John Swift, P.T.
• Synergy Medical Group
• Synergy Medical Group LLC
• Synergy Medical Group, LLC
• Lilytte Tagala, PHARM.D
• Sahar Taghvaei
• Mariam Halicia Taherian, RN
• Take Charge Wellness and Counseling
• Ann Douglass Taliaferro, CSC-AD

• Podiatrist in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Podiatrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2011; 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.