Organization Active NPI

William J Oneill

Doing business as Carolina Foot Care Assoc PLLC

  • Podiatrist
  • Clemmons, NC
National Provider Identifier
1881643419
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
WILLIAM J ONEILL
Doing business as
Carolina Foot Care Assoc PLLC
Practice address
6341 Cook Ave
Suite a
Clemmons, NC 27012-9379
Phone
(336) 766-8400
Fax
(336) 766-8486
NPI assigned
May 10, 2006
Last updated
Sep 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

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

Authorized official

Name
Mrs. Paula B Reavis
Title
Business MGR
Phone
(336) 766-8400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X Primary

Addresses

Primary practice location

6341 Cook Ave
Suite a
Clemmons, NC 27012-9379

Mailing address

PO Box 268
Clemmons, NC 27012-0268
Phone (336) 766-8400

Other identifiers 2

IdentifierTypeStateIssuer
8908042MedicaidNC
08042OtherNCBLUE CROSS OF NC

Other names 1

  • CAROLINA FOOT CARE ASSOC PLLC Doing business as

National Provider Directory

National Provider Directory

Locations

6341 Cook Ave
Ste A
Clemmons, NC 27012
Phone (336) 766-8400

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442793600000",
    "number": "1881643419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270120268",
            "telephone_number": "336-766-8400",
            "fax_number": "336-766-8486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6341 COOK AVE",
            "address_2": "SUITE A",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270129379",
            "telephone_number": "336-766-8400",
            "fax_number": "336-766-8486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM J ONEILL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2015-09-21",
        "status": "A",
        "authorized_official_last_name": "REAVIS",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "BUSINESS MGR",
        "authorized_official_telephone_number": "336-766-8400",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908042",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF NC",
            "identifier": "08042",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CAROLINA FOOT CARE ASSOC PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clemmons, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; 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.