Organization Active NPI

Mid-Ohio Podiatry Inc

  • Podiatrist
  • Shelby, OH
National Provider Identifier
1831160498
Registry record updated Apr 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
MID-OHIO PODIATRY INC
Practice address
110 W Smiley Ave
Shelby, OH 44875
Phone
(419) 342-6351
Fax
(419) 347-1697
NPI assigned
Jan 31, 2006
Last updated
Apr 19, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2011

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

Authorized official

Name
Mrs. Paula Kay Albright
Title
Secretary
Phone
(419) 342-6351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

110 W Smiley Ave
Shelby, OH 44875

Mailing address

PO Box 5005
Shelby, OH 44875-5005
Phone (419) 342-6351

Other identifiers 2

IdentifierTypeStateIssuer
0704956MedicaidOH
C14898OtherOHRAILROAD MEDICARE

Other names 1

  • William Mako Jr DPM Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051205000752 OH Part B Supplier - Clinic/Group Practice 6608896626 Receives reassigned benefits from 1 practitioner
Practice locations: Shelby, OH
O20100930071698 OH DME Supplier - Physician - Podiatry 6608896626 Practice locations: Shelby, OH

National Provider Directory

National Provider Directory

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": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303171200000",
    "number": "1831160498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5005",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "448755005",
            "telephone_number": "419-342-6351",
            "fax_number": "419-347-1697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W SMILEY AVE",
            "city": "SHELBY",
            "state": "OH",
            "postal_code": "44875",
            "telephone_number": "419-342-6351",
            "fax_number": "419-347-1697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-OHIO PODIATRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2011-04-19",
        "status": "A",
        "authorized_official_last_name": "ALBRIGHT",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "419-342-6351",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0704956",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "C14898",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "William Mako Jr DPM Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Shelby, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; 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.