Northeast Ohio Foot and Ankle Specialists LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

36003689 Issued in OH

Legal business name

NORTHEAST OHIO FOOT AND ANKLE SPECIALISTS LLC

Doing business as

Luckino Foot & Ankle Associates

Practice address

4900 Frank Ave NW
Canton, OH 44720-7483

Phone

(330) 477-6265

Fax

(330) 477-6306

NPI assigned

Sep 19, 2017

Last updated

Dec 19, 2023By 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. Frank Luckino, DPMNPI 1801187570

Title

Owner

Phone

(330) 477-6265

Specialties & licenses 1

Addresses

Other names 1

• Luckino Foot & Ankle Associates Doing business as

Medicare fee-for-service enrollment

Enrolled in OH2 enrollments

Enrollment records 2

Locations

Practitioners 2

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.

• Frank A Luckino III, DPM

  • Foot & Ankle Surgery Podiatrist
  • Youngstown, OH
  • NPI 1801187570
  Medicare reassignment NPD Authorized official
• Marna Marie Revlock, APRN

  • Adult Health Nurse Practitioner
  • Canton, OH
  • NPI 1407512304
  Medicare reassignment NPD

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

{
    "created_epoch": "1505779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1922527118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 FRANK AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447207483",
            "telephone_number": "330-477-6265",
            "fax_number": "330-477-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 FRANK AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447207483",
            "telephone_number": "330-477-6265",
            "fax_number": "330-477-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST OHIO FOOT AND ANKLE SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-19",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "LUCKINO",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-477-6265",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36003689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Luckino Foot & Ankle Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Luckino Foot & Ankle Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Not Forsaken

• Foot & Ankle Surgery Podiatrist in Canton, OH
• Providers in Canton, OH by specialty
• Foot & Ankle Surgery Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2023; 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.