NPIMap

Organization Active NPI

Healthdrive Podiatry Group, PC

Doing business as HealthDrive Podiatry Group

  • Durable Medical Equipment & Medical Supplies
  • Brookfield, WI
National Provider Identifier
1811087158
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
HEALTHDRIVE PODIATRY GROUP, PC
Doing business as
HealthDrive Podiatry Group
Practice address
200 S Executive Dr
Suite 101
Brookfield, WI 53005-4216
Phone
(414) 535-8134
Fax
(414) 535-8135
NPI assigned
Oct 16, 2006
Last updated
Jan 2, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
HEALTHDRIVE PODIATRY GROUP, PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Authorized official

Name
Dr. Shadi Adib Abboud, DPMNPI 1083704860
Title
Treasuer/Practice Director
Phone
(857) 255-0486

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

200 S Executive Dr
Suite 101
Brookfield, WI 53005-4216

Mailing address

100 Crossing Blvd
Suite 300
Framingham, MA 01702-5555
Phone (617) 964-6681

Other names 1

  • HealthDrive Podiatry Group Doing business as

National Provider Directory

National Provider Directory
Part of
Diadra M Wright DPM

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577923200000",
    "number": "1811087158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CROSSING BLVD",
            "address_2": "SUITE 300",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017025555",
            "telephone_number": "617-964-6681",
            "fax_number": "339-686-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S EXECUTIVE DR",
            "address_2": "SUITE 101",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054216",
            "telephone_number": "414-535-8134",
            "fax_number": "414-535-8135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHDRIVE PODIATRY GROUP, PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HEALTHDRIVE PODIATRY GROUP, PC",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A",
        "authorized_official_last_name": "ABBOUD",
        "authorized_official_first_name": "SHADI",
        "authorized_official_middle_name": "ADIB",
        "authorized_official_title_or_position": "TREASUER/PRACTICE DIRECTOR",
        "authorized_official_telephone_number": "857-255-0486",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HealthDrive Podiatry Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "HealthDrive Podiatry Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2020; 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.