Organization Active NPI

Fannin Podiatry LLC

  • Primary Podiatric Medicine Podiatrist
  • Galion, OH
National Provider Identifier
1902103898
Registry record updated Feb 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
36002701 Issued in OH
Legal business name
FANNIN PODIATRY LLC
Practice address
315 N Market St
Galion, OH 44833-1923
Phone
(419) 468-6222
Fax
(419) 468-8259
NPI assigned
Feb 11, 2011
Last updated
Feb 11, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2011

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

Authorized official

Name
Dr. Lori A Fannin, DPMNPI 1295714012
Title
Owner
Phone
(419) 468-6222

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
Primary Podiatric Medicine Podiatrist 213EP1101X 36002701 OH Primary

Addresses

Primary practice location

315 N Market St
Galion, OH 44833-1923

Mailing address

315 N Market St
Galion, OH 44833-1923
Phone (419) 468-6222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110222000681 OH Part B Supplier - Clinic/Group Practice 9234310483 Receives reassigned benefits from 1 practitioner
Practice locations: Bucyrus, OH; Crestline, OH; Galion, OH

National Provider Directory

National Provider Directory

Locations

315 N Market St
Galion, OH 44833
Phone (419) 468-6222

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": "1297382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297382400000",
    "number": "1902103898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N MARKET ST",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448331923",
            "telephone_number": "419-468-6222",
            "fax_number": "419-468-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N MARKET ST",
            "city": "GALION",
            "state": "OH",
            "postal_code": "448331923",
            "telephone_number": "419-468-6222",
            "fax_number": "419-468-8259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANNIN PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-11",
        "last_updated": "2011-02-11",
        "status": "A",
        "authorized_official_last_name": "FANNIN",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-468-6222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "OH",
            "license": "36002701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galion, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; 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.