NPIMap

Organization Active NPI

Personal Footcare LLC

  • Durable Medical Equipment & Medical Supplies
  • South Hill, VA
National Provider Identifier
1861746059
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0103000377 Issued in VA
Legal business name
PERSONAL FOOTCARE LLC
Practice address
424 Bracey LN
South Hill, VA 23970-1631
Phone
(434) 447-6988
Fax
(434) 447-5850
NPI assigned
Nov 9, 2012
Organization subpart
Yes
Parent organization
PERSONAL FOOTCARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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

Authorized official

Name
Dr. Samuel Winfred Person, D.P.M.NPI 1154324879
Title
President/Podiatrist
Phone
(804) 732-1211

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
Durable Medical Equipment & Medical Supplies 332B00000X 0103000377 VA Primary

Addresses

Primary practice location

424 Bracey LN
South Hill, VA 23970-1631

Mailing address

2020 Wakefield Ave
Petersburg, VA 23805-2112
Phone (804) 732-1211

National Provider Directory

National Provider Directory
Part of
Personal Footcare LLC

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1352419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352419200000",
    "number": "1861746059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 WAKEFIELD AVE",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238052112",
            "telephone_number": "804-732-1211",
            "fax_number": "804-733-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 BRACEY LN",
            "city": "SOUTH HILL",
            "state": "VA",
            "postal_code": "239701631",
            "telephone_number": "434-447-6988",
            "fax_number": "434-447-5850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL FOOTCARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PERSONAL FOOTCARE LLC",
        "enumeration_date": "2012-11-09",
        "last_updated": "2012-11-09",
        "status": "A",
        "authorized_official_last_name": "PERSON",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "WINFRED",
        "authorized_official_title_or_position": "PRESIDENT/PODIATRIST",
        "authorized_official_telephone_number": "804-732-1211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "VA",
            "license": "0103000377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Hill, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.