Maryland Foot & Ankle Reconstruction Group LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

01623 Issued in MD

Legal business name

MARYLAND FOOT & ANKLE RECONSTRUCTION GROUP LLC

Practice address

14301 Autumn Gold Rd
Boyds, MD 20841-4208

Phone

(571) 830-7983

NPI assigned

Jul 11, 2017

Organization subpart

No

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

Authorized official

Name

Navid Sadoughi, DPM

Title

Doctor of Podiatric Medicine

Phone

(571) 830-7983

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1499731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1922520063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14301 AUTUMN GOLD RD",
            "city": "BOYDS",
            "state": "MD",
            "postal_code": "208414208",
            "telephone_number": "571-830-7983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14301 AUTUMN GOLD RD",
            "city": "BOYDS",
            "state": "MD",
            "postal_code": "208414208",
            "telephone_number": "571-830-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND FOOT & ANKLE RECONSTRUCTION GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-11",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SADOUGHI",
        "authorized_official_first_name": "NAVID",
        "authorized_official_title_or_position": "DOCTOR OF PODIATRIC MEDICINE",
        "authorized_official_telephone_number": "571-830-7983",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MD",
            "license": "01623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meeja Kinsey, ATC
• Murray H Kramer, LCSW-C
• Rebekah A Machiela, MSW, LCSW-C
• Stanley Robert Manstof, DDS
• Courtney Markey, LMSW
• Miko Yvette Tillman Masterson, LCSW-C
• Cameron Skylar Mattison, MD
• Patricia Anne McKinley, CRNFA
• Bridget Foretia Meyers
• Nathalie J Miller, OTR/L

• All providers in Boyds, MD
• Foot & Ankle Surgery Podiatrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.