NPIMap

Organization Active NPI

Ankle & Foot Center of Tampa Bay

  • Podiatric Clinic/Center
  • Brooksville, FL
National Provider Identifier
1871068007
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
ANKLE & FOOT CENTER OF TAMPA BAY
Practice address
11373 Cortez Blvd Ste 305
Brooksville, FL 34613-5411
Phone
(352) 596-8348
Fax
(352) 596-7051
NPI assigned
Oct 3, 2018
Last updated
Oct 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Authorized official

Name
Robert E Creighton, DPM
Title
Member
Phone
(813) 254-4747

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X NU Primary

Addresses

Primary practice location

11373 Cortez Blvd Ste 305
Brooksville, FL 34613-5411

Mailing address

2835 W de Leon St
Tampa, FL 33609-5518
Phone (813) 254-4747

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181106000615 FL DME Supplier - Physician - Podiatry 9133187107 Practice locations: Brooksville, FL

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Ankle Foot Center of6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2835 W De Leon St
Tampa, FL 33609

NPI Registry JSON

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

{
    "created_epoch": "1538524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1871068007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 W DE LEON ST",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336095518",
            "telephone_number": "813-254-4747",
            "fax_number": "813-254-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11373 CORTEZ BLVD STE 305",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346135411",
            "telephone_number": "352-596-8348",
            "fax_number": "352-596-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANKLE & FOOT CENTER OF TAMPA BAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-03",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "CREIGHTON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "813-254-4747",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooksville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.