NPIMap

Organization Active NPI

Foot and Ankle Management Group LLC

  • Foot & Ankle Surgery Podiatrist
  • Naples, FL
National Provider Identifier
1932112349
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO 1760 Issued in FL
Legal business name
FOOT AND ANKLE MANAGEMENT GROUP LLC
Practice address
681 Goodlette Rd N
Suite 160
Naples, FL 34102-5458
Phone
(239) 263-0200
Fax
(239) 263-8435
NPI assigned
Aug 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2020

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

Authorized official

Name
Mr. Mark Stevenson, CMRS
Title
Office Manager
Phone
(239) 263-0200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X PO 1760 FL Primary

Addresses

Primary practice location

681 Goodlette Rd N
Suite 160
Naples, FL 34102-5458

Mailing address

681 Goodlette Rd N
Suite 160
Naples, FL 34102-5458
Phone (239) 263-0200

Other identifiers 1

IdentifierTypeStateIssuer
98023OtherFLBLUECROSS AND BLUESHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060123000892 FL Part B Supplier - Clinic/Group Practice 1557385093 Receives reassigned benefits from 7 practitioners
Practice locations: Naples, FL
O20100930017937 FL DME Supplier - Physician - Podiatry 1557385093 Practice locations: Naples, FL

National Provider Directory

National Provider Directory
Tax ID family
Foot and Ankle Management Group LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

815 Bald Eagle Dr
Marco Island, FL 34145

1310 San Marco Rd
Ste A
Marco Island, FL 34145

1280 Creekside Blvd E
Ste 106
Naples, FL 34109

Practitioners & affiliated clinicians

Practitioners 7

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": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588118400000",
    "number": "1932112349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 GOODLETTE RD N",
            "address_2": "SUITE 160",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025458",
            "telephone_number": "239-263-0200",
            "fax_number": "239-263-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 GOODLETTE RD N",
            "address_2": "SUITE 160",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341025458",
            "telephone_number": "239-263-0200",
            "fax_number": "239-263-8435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE MANAGEMENT GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A",
        "authorized_official_last_name": "STEVENSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "239-263-0200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CMRS"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO 1760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS AND BLUESHIELD",
            "identifier": "98023",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2020; 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.