Blpodiatry LLC
Organization Active NPI Primary Podiatric Medicine Podiatrist · Suwanee, GA
NPI 1841997228 · NPPES record last updated Jan 2, 2025
Key facts
- NPI
- 1841997228
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Podiatric Medicine Podiatrist 213EP1101X
- Legal business name
- BLPODIATRY LLC
- Practice address
- 1325 Satellite Blvd NW Ste 701a
Suwanee, GA 30024-4676 - Phone
- (302) 753-8294
- NPI assigned
- Feb 15, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. Brian Lee
- Title
- President / Podiatrist
- Phone
- (770) 765-1237
Practitioners 1
-
Brian Lee, DPM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230721002640 | GA | Part B Supplier - Clinic/Group Practice | 3870953839 |
Receives reassigned benefits from 1 practitioner Practice locations: Suwanee,, GA |
National Provider Directory
Locations
3120 Crossing Park
Norcross, GA 30071
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Podiatric Medicine Podiatrist |
213EP1101X | Yes |
Addresses
Primary practice location
1325 Satellite Blvd NW Ste 701a
Suwanee, GA 30024-4676
Mailing address
4191 Baverton Dr
Suwanee, GA 30024-8725
Other providers in Suwanee, GA
- Brantley Black Bruce
- Lisa Black
- Evan Blackburn
- Brittany Bledsoe
- Blossom Pediatric Dentistry, LLC
- Emily Blum
- Emily Rose Bolt
- Elizabeth Bonet
- Ashante Booker
- Andria Booth
All providers in Suwanee, GA · Primary Podiatric Medicine Podiatrist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 2, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.