Organization Active NPI

Foot & Ankle Associates of North Carolina, PLLC

  • Foot & Ankle Surgery Podiatrist
  • Rocky Mount, NC
National Provider Identifier
1790873503
Registry record updated Mar 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FOOT & ANKLE ASSOCIATES OF NORTH CAROLINA, PLLC
Practice address
740 Sutters Creek Blvd
Rocky Mount, NC 27804-8429
Phone
(252) 451-4040
Fax
(252) 451-8040
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2022

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

Authorized official

Name
Dr. Clarence Stewart, DPMNPI 1669458915
Title
Partner
Phone
(919) 231-7969

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

740 Sutters Creek Blvd
Rocky Mount, NC 27804-8429

Mailing address

PO Box 14759
Raleigh, NC 27620-4759
Phone (919) 231-7969

Other identifiers 3

IdentifierTypeStateIssuer
CK8360OtherNCPALMETTO GBA-RAILROAD ME
0809WOtherNCBLUE CROSS BLUE SHEILD GP
690187EMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20050314000043 NC Part B Supplier - Clinic/Group Practice 2365497385 Receives reassigned benefits from 5 practitioners
Practice locations: Clayton, NC; Raleigh, NC; Rocky Mount, NC; Wilson, NC
O20100930057160 NC DME Supplier - Physician - General Practice 2365497385 Practice locations: Rocky Mount, NC
O20220525000582 NC Part B Supplier - Independent Clinical Laboratory 2365497385 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Raleigh, NC

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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

Locations

1202 Dr Martin Luther King Jr Dr N
Ahoskie, NC 27910
Phone (252) 862-4300

320 Veterans Pkwy
Ste 100
Clayton, NC 27520

Practitioners & affiliated clinicians

Practitioners 5

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": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1790873503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14759",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276204759",
            "telephone_number": "919-231-7969",
            "fax_number": "919-231-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "740 SUTTERS CREEK BLVD",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048429",
            "telephone_number": "252-451-4040",
            "fax_number": "252-451-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE ASSOCIATES OF NORTH CAROLINA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "919-231-7969",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RAILROAD ME",
            "identifier": "CK8360",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD GP",
            "identifier": "0809W",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "690187E",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rocky Mount, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; 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.