Panhandle Podiatry PLLC

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

WV00358 Issued in WV

Legal business name

PANHANDLE PODIATRY PLLC

Practice address

489 Mid Atlantic Parkway
Suite 1
Martinsburg, WV 25404-3594

Phone

(304) 267-3030

Fax

(304) 267-0660

NPI assigned

Oct 26, 2007

Organization subpart

No

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

Authorized official

Name

Jennifer Fallon Mollica

Title

Office Manager

Phone

(304) 267-3030

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

Enrollment records 1

Locations

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457049600000",
    "number": "1841479813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1961",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254021961",
            "telephone_number": "304-267-3030",
            "fax_number": "304-267-0660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 MID ATLANTIC PARKWAY",
            "address_2": "SUITE 1",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254043594",
            "telephone_number": "304-267-3030",
            "fax_number": "304-267-0660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PANHANDLE PODIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2016-03-04",
        "status": "A",
        "authorized_official_last_name": "MOLLICA",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "FALLON",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-267-3030"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "WV",
            "license": "WV00358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2102009000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Panhandle Gastroenterology, PLLC
• Panhandle Home Health Inc
• Panhandle Medical Assoc PLLC
• Panhandle Medicine PLLC
• Panhandle Neurology Center, Inc.
• Panhandle Psychological Center, P.L.L.C.
• Panhandle Sleep Medicine, PLLC
• Monica Paniagua-Ramirez
• Ruza Papeskov
• Parasimple LLC

• Primary Podiatric Medicine Podiatrist in Martinsburg, WV
• Providers in Martinsburg, WV by specialty
• Primary Podiatric Medicine Podiatrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2016; 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.