NPIMap

Organization Active NPI

Carolina Podiatry Associates, LLC

  • Specialist
  • Raeford, NC
National Provider Identifier
1881624955
Registry record updated Aug 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
24580 Issued in NC
Legal business name
CAROLINA PODIATRY ASSOCIATES, LLC
Practice address
402 S Main St
Raeford, NC 28376-3223
Phone
(910) 904-0648
Fax
(910) 904-1810
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2008

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

Authorized official

Name
Mrs. Anita B Nettles
Title
Office Manager
Phone
(910) 904-0648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 24580 NC Primary

Addresses

Primary practice location

402 S Main St
Raeford, NC 28376-3223

Mailing address

P O Box 777
Raeford, NC 28376-2527
Phone (910) 904-0648

Other identifiers 2

IdentifierTypeStateIssuer
016TMOtherNCBLUECROSSBLUESHIELD NUMBE
89016TMMedicaidNC

Other names 1

  • CAROLINA PODIATRY & MEDICAL SPECIALTIES Doing business as

National Provider Directory

National Provider Directory

Locations

402 S Main St
#200
Raeford, NC 28376
Phone (910) 875-9364

Practitioners & affiliated clinicians

Practitioners 3

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": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219363200000",
    "number": "1881624955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 777",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283762527",
            "telephone_number": "910-904-0648",
            "fax_number": "910-904-1810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S MAIN ST",
            "city": "RAEFORD",
            "state": "NC",
            "postal_code": "283763223",
            "telephone_number": "910-904-0648",
            "fax_number": "910-904-1810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA PODIATRY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2008-08-22",
        "status": "A",
        "authorized_official_last_name": "NETTLES",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "910-904-0648",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": "24580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD NUMBE",
            "identifier": "016TM",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89016TM",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAROLINA PODIATRY & MEDICAL SPECIALTIES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Raeford, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2008; 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.