Providence Foot & Ankle Centers, P.C., Inc.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

PROVIDENCE FOOT & ANKLE CENTERS, P.C., INC.

Practice address

865 Thornton Rd
Suite B
Lithia Springs, GA 30122-2607

Phone

(770) 745-4224

Fax

(770) 790-4752

NPI assigned

Aug 13, 2008

Organization subpart

No

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

Authorized official

Name

Adrienne M. Atkinson-Sneed, D.P.M.

Title

C.E.O.

Phone

(770) 745-4224

Specialties & licenses 5

Addresses

Other identifiers 3

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

{
    "created_epoch": "1218585600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334793600000",
    "number": "1790931483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3886 PRINCETON LAKES WAY SW",
            "address_2": "SUITE 140A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315511",
            "telephone_number": "770-745-4224",
            "fax_number": "770-790-4752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 THORNTON RD",
            "address_2": "SUITE B",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301222607",
            "telephone_number": "770-745-4224",
            "fax_number": "770-790-4752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE FOOT & ANKLE CENTERS, P.C., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-13",
        "last_updated": "2012-04-19",
        "status": "A",
        "authorized_official_last_name": "ATKINSON-SNEED",
        "authorized_official_first_name": "ADRIENNE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "C.E.O.",
        "authorized_official_telephone_number": "770-745-4224",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ER0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GA (CAHABA GBA) GROUP PTAN",
            "identifier": "511G700902",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME (PALMETTO GBA NSC) GROUP PTAN FOR THORNTON",
            "identifier": "6169580003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR (PALMETTO GBA) GROUP PTAN",
            "identifier": "DQ9092",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.