Centerville Podiatry LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

DPM277 Issued in RI

Legal business name

CENTERVILLE PODIATRY LLC

Practice address

469 Centerville Rd
Ste 105
Warwick, RI 02886-4354

Phone

(401) 738-9200

Fax

(401) 738-9400

NPI assigned

Sep 12, 2016

Organization subpart

No

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

Authorized official

Name

Dr. George M Moniz, DPM

Title

Owner

Phone

(401) 738-9200

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1473638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473638400000",
    "number": "1871041491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 CENTERVILLE RD",
            "address_2": "STE 105",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864354",
            "telephone_number": "401-738-9200",
            "fax_number": "401-738-9400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 CENTERVILLE RD",
            "address_2": "STE 105",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864354",
            "telephone_number": "401-738-9200",
            "fax_number": "401-738-9400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERVILLE PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-12",
        "last_updated": "2016-09-12",
        "status": "A",
        "authorized_official_last_name": "MONIZ",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-738-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "RI",
            "license": "DPM277",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "RI",
            "license": "DPM208",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Warwick, RI
• Providers in Warwick, RI by specialty
• Foot & Ankle Surgery Podiatrist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2016; 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.