Active NPI
Robert P. Bewley, DPM, PA
Doing business as Lakeside Centre for Podiatry
- Podiatrist
- Leesburg, FL
National Provider Identifier
1811901119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- PO693
- Legal business name
- ROBERT P. BEWLEY, DPM, PA
- Doing business as
- Lakeside Centre for Podiatry
- Practice address
- 601 E Dixie Ave
Plaza 804
Leesburg, FL 34748-5953 - Phone
- (352) 728-1252
- Fax
- (352) 728-0079
- NPI assigned
- Jul 29, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert P Bewley, D.P.M.
- Title
- Owner
- Phone
- (352) 728-1252
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | PO693 | FL | Primary |
Addresses
Primary practice location
601 E Dixie Ave
Plaza 804
Leesburg, FL 34748-5953
Mailing address
601 E Dixie Ave
Plaza 804
Leesburg, FL 34748-5953
Phone (352) 728-1252
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 45125 | Other | FL | BLUE CROSS/BLUE SHIELD |
| CF7533 | Other | FL | RAILROAD MEDICARE |
| K1457 | Other | FL | MEDICARE PTAN |
Other names 1
- Lakeside Centre for Podiatry
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154131200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1207612800000",
"number": "1811901119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 E DIXIE AVE",
"address_2": "PLAZA 804",
"city": "LEESBURG",
"state": "FL",
"postal_code": "347485953",
"telephone_number": "352-728-1252",
"fax_number": "352-728-0079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 E DIXIE AVE",
"address_2": "PLAZA 804",
"city": "LEESBURG",
"state": "FL",
"postal_code": "347485953",
"telephone_number": "352-728-1252",
"fax_number": "352-728-0079"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROBERT P. BEWLEY, DPM, PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-29",
"last_updated": "2008-04-08",
"status": "A",
"authorized_official_last_name": "BEWLEY",
"authorized_official_first_name": "ROBERT",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "352-728-1252",
"authorized_official_credential": "D.P.M."
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "FL",
"license": "PO693",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "45125",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CF7533",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "K1457",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Lakeside Centre for Podiatry",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Leesburg, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.