Organization Active NPI

Sunshine Podiatry LLC

  • Podiatric Clinic/Center
  • Riverview, FL
National Provider Identifier
1891318879
Registry record updated Aug 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
SUNSHINE PODIATRY LLC
Practice address
11918 Balm Riverview Rd
Riverview, FL 33569-6601
Phone
(813) 522-6522
Fax
(813) 658-6238
NPI assigned
May 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2022

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

Authorized official

Name
Huy Nguyen, DPMNPI 1134512379
Title
Owner
Phone
(510) 206-7935

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

11918 Balm Riverview Rd
Riverview, FL 33569-6601

Mailing address

6910 Neopolitan CT
Apollo Beach, FL 33572-1604
Phone (510) 206-7935

Other identifiers 1

IdentifierTypeStateIssuer
106709700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20200608002797 FL DME Supplier - Physician - General Practice 7113348624 Practice locations: Riverview, FL
O20200611001639 FL Part B Supplier - Clinic/Group Practice 7113348624 Receives reassigned benefits from 1 practitioner
Practice locations: Riverview, FL

National Provider Directory

National Provider Directory

Locations

11918 Balm Riverview Rd
Riverview, FL 33569
Phone (813) 522-6522

Practitioners & affiliated clinicians

Practitioners 1

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": "1590364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660003200000",
    "number": "1891318879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6910 NEOPOLITAN CT",
            "city": "APOLLO BEACH",
            "state": "FL",
            "postal_code": "335721604",
            "telephone_number": "510-206-7935",
            "fax_number": "813-658-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11918 BALM RIVERVIEW RD",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335696601",
            "telephone_number": "813-522-6522",
            "fax_number": "813-658-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-25",
        "last_updated": "2022-08-09",
        "certification_date": "2022-08-09",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "HUY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-206-7935",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106709700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverview, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2022; 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.