Connecticut Foot Specialists, P.C.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

CT000793 Issued in CT

Legal business name

CONNECTICUT FOOT SPECIALISTS, P.C.

Practice address

43 Woodland St
Suite 210
Hartford, CT 06105-2363

Phone

(260) 251-7200

NPI assigned

May 11, 2010

Last updated

Jun 4, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Brian K Wagner, D.P.M.

Title

Owner

Phone

(860) 653-4708

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1273536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275609600000",
    "number": "1902124225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WOODLAND ST",
            "address_2": "SUITE 210",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052363",
            "telephone_number": "860-251-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 WOODLAND ST",
            "address_2": "SUITE 210",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052363",
            "telephone_number": "260-251-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONNECTICUT FOOT SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-11",
        "last_updated": "2010-06-04",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-653-4708",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "CT",
            "license": "CT000793",
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "CT",
            "license": "CT000793",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Hartford, CT
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• Podiatrist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; 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.