NPIMap

Organization Active NPI

Premier Foot Care, Inc.

  • Podiatrist
  • Bay Minette, AL
National Provider Identifier
1811932312
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
PREMIER FOOT CARE, INC.
Practice address
106 S US Highway 31
Bay Minette, AL 36507-2846
Phone
(251) 580-0481
NPI assigned
Jun 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Authorized official

Name
Dr. Jeffrey Martin Dull, DPMNPI 1275560344
Title
Vice President
Phone
(251) 580-0481

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

106 S US Highway 31
Bay Minette, AL 36507-2846

Mailing address

106 S US Highway 31
Bay Minette, AL 36507-2846
Phone (251) 580-0481

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050929000262 AL Part B Supplier - Clinic/Group Practice 7113952011 Receives reassigned benefits from 2 practitioners
Practice locations: Satsuma, AL; Spanish Fort, AL; Mobile, AL; Fairhope, AL; Daphne, AL; Citronelle, AL; Bay Minette, AL
O20100930087289 AL DME Supplier - Physician - Podiatry 7113952011 Practice locations: Bay Minette, AL

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Premier Foot Care Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

106 S US Highway 31
Bay Minette, AL 36507
Phone (251) 580-0481

Practitioners & affiliated clinicians

Practitioners 2

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": "1150588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1811932312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S US HIGHWAY 31",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365072846",
            "telephone_number": "251-580-0481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 S US HIGHWAY 31",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365072846",
            "telephone_number": "251-580-0481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER FOOT CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-18",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "DULL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "251-580-0481",
        "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": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Minette, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.