NPIMap

Organization Active NPI

Eastern Shore Family Foot Care, LLC

  • Foot & Ankle Surgery Podiatrist
  • Denton, MD
National Provider Identifier
1891170619
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
EASTERN SHORE FAMILY FOOT CARE, LLC
Practice address
510 S 5TH Ave
Denton, MD 21629-1368
Phone
(410) 819-0096
Fax
(410) 479-4622
NPI assigned
Jul 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Authorized official

Name
Kimberli Clarkson
Title
Office Manager
Phone
(410) 758-5446

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary
Podiatric Clinic/Center 261QP1100X
Durable Medical Equipment & Medical Supplies 332B00000X
Customized Equipment (DME) 332BC3200X

Addresses

Primary practice location

510 S 5TH Ave
Denton, MD 21629-1368

Mailing address

6412 Church Hill Rd
Chestertown, MD 21620-2386
Phone (410) 778-1801

National Provider Directory

National Provider Directory
Tax ID family
Eastern Shore Family Ft LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

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": "1437523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735257600000",
    "number": "1891170619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6412 CHURCH HILL RD",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216202386",
            "telephone_number": "410-778-1801",
            "fax_number": "410-758-3249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S 5TH AVE",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216291368",
            "telephone_number": "410-819-0096",
            "fax_number": "410-479-4622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORE FAMILY FOOT CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-22",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A",
        "authorized_official_last_name": "CLARKSON",
        "authorized_official_first_name": "KIMBERLI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "410-758-5446"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.