NPIMap

Organization Active NPI

Foot and Ankle Center of Augusta

  • Podiatrist
  • Augusta, GA
National Provider Identifier
1922272012
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
000619 Issued in GA
Legal business name
FOOT AND ANKLE CENTER OF AUGUSTA
Practice address
1142 Druid Park Ave
Augusta, GA 30904-5850
Phone
(706) 739-0020
Fax
(706) 739-0024
NPI assigned
Apr 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Authorized official

Name
Latanya Fyne, MDNPI 1275643710
Title
Physician
Phone
(706) 739-0020

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X 000619 GA Primary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 000619 GA

Addresses

Primary practice location

1142 Druid Park Ave
Augusta, GA 30904-5850

Mailing address

1142 Druid Park Ave
Augusta, GA 30904-5850
Phone (706) 739-0020

Other identifiers 1

IdentifierTypeStateIssuer
00428975BMedicaidGA

National Provider Directory

National Provider Directory

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": "1208476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208476800000",
    "number": "1922272012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1142 DRUID PARK AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309045850",
            "telephone_number": "706-739-0020",
            "fax_number": "706-739-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1142 DRUID PARK AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309045850",
            "telephone_number": "706-739-0020",
            "fax_number": "706-739-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE CENTER OF AUGUSTA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-18",
        "last_updated": "2008-04-18",
        "status": "A",
        "authorized_official_last_name": "FYNE",
        "authorized_official_first_name": "LATANYA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "706-739-0020",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "GA",
            "license": "000619",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "000619",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00428975B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.