NPIMap

Organization Active NPI

North East Foot Clinic

  • Foot Surgery Podiatrist
  • North East, PA
National Provider Identifier
1902011125
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
SC003377L Issued in PA
Legal business name
NORTH EAST FOOT CLINIC
Practice address
90 E Main St
Suite 3
North East, PA 16428-1319
Phone
(814) 725-2715
Fax
(814) 725-5186
NPI assigned
May 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Morgan Timothy Holmes, D.P.M.
Title
Owner
Phone
(814) 725-2715

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X SC003377L PA Primary

Addresses

Primary practice location

90 E Main St
Suite 3
North East, PA 16428-1319

Mailing address

90 E Main St
Suite 3
North East, PA 16428-1319
Phone (814) 725-2715

Other identifiers 1

IdentifierTypeStateIssuer
0012954200006MedicaidPA

National Provider Directory

National Provider Directory

Locations

90 E Main St
Ste 3
North East, PA 16428
Phone (814) 725-2715

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902011125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 E MAIN ST",
            "address_2": "SUITE 3",
            "city": "NORTH EAST",
            "state": "PA",
            "postal_code": "164281319",
            "telephone_number": "814-725-2715",
            "fax_number": "814-725-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 E MAIN ST",
            "address_2": "SUITE 3",
            "city": "NORTH EAST",
            "state": "PA",
            "postal_code": "164281319",
            "telephone_number": "814-725-2715",
            "fax_number": "814-725-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH EAST FOOT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_middle_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "814-725-2715",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "PA",
            "license": "SC003377L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0012954200006",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North East, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.