Premier Foot Clinic PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

80151 Issued in MS

Legal business name

PREMIER FOOT CLINIC PC

Practice address

705 Highway 80 W
Clinton, MS 39056-4103

Phone

(601) 926-1500

Fax

(601) 926-1502

NPI assigned

Dec 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Stefanie Monique Thomas, DPMNPI 1497864698

Title

Owner President

Phone

(601) 926-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/9847/brand/1/csg/1/fhir/r4
• FHIR API: https://fhir4.healow.com/fhir/r4/GHJHBD

Practitioners 2

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

• Stefanie Monique Thomas, DPM

  • Podiatrist
  • Clinton, MS
  • NPI 1497864698
  Medicare reassignment NPD Authorized official
• Renita Ta'Sha Shaw, DPM

  • Foot Surgery Podiatrist
  • Wiggins, MS
  • NPI 1376783324
  NPD (past)

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1790840080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 HIGHWAY 80 W",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564103",
            "telephone_number": "601-926-1500",
            "fax_number": "601-926-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 HIGHWAY 80 W",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390564103",
            "telephone_number": "601-926-1500",
            "fax_number": "601-926-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER FOOT CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "STEFANIE",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "601-926-1500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MS",
            "license": "80151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06981282",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Physician Hospice Care 2 LLC
• Brittany Michelle Pippins, LCSW
• Cynthia Leanna Pittman
• James Pittman, MS,PCMHT
• Abby Hall Pitts
• Rebecca Brooks Prewitt, EDS, LCSW
• Rachel Lani Price
• Prime Care Clinic of Clinton, LLC
• Provision Processing Solutions LLC
• Psychological Consultants PA

• Podiatrist in Clinton, MS
• Providers in Clinton, MS by specialty
• Podiatrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.