Active NPI
Podiatric Surgi Center Inc
- Ambulatory Surgical Clinic/Center
- Norwalk, OH
National Provider Identifier
1942206677
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- PODIATRIC SURGI CENTER INC
- Practice address
- 64 Executive Dr
Norwalk, OH 44857-9568 - Phone
- (419) 663-3338
- NPI assigned
- Jun 27, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. James Revelas, D.P.M.
- Title
- Owner
- Phone
- (419) 663-3338
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | OH | Primary |
Addresses
Primary practice location
64 Executive Dr
Norwalk, OH 44857-9568
Mailing address
64 Executive Dr
Norwalk, OH 44857-9568
Phone (419) 663-3338
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Ambulatory surgical center certification: CCN 36C0001104
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- PODIATRIC SURGICENTER
- Certification status
- Active
- Provider type (POS)
- Ambulatory surgical center
- Participating since
- May 13, 1998
- Last certification
- May 19, 2006
- Ownership / control type
- Proprietary
- Facility address
- 64 Executive Dr
Norwalk, OH 44857
National Provider Directory
National Provider DirectoryLocations
64 Executive Dr
Norwalk, OH 44857
Phone (419) 663-3338
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119830400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1658361600000",
"number": "1942206677",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 EXECUTIVE DR",
"city": "NORWALK",
"state": "OH",
"postal_code": "448579568",
"telephone_number": "419-663-3338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "64 EXECUTIVE DR",
"city": "NORWALK",
"state": "OH",
"postal_code": "448579568",
"telephone_number": "419-663-3338"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PODIATRIC SURGI CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-27",
"last_updated": "2022-07-21",
"status": "A",
"authorized_official_last_name": "REVELAS",
"authorized_official_first_name": "JAMES",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "419-663-3338",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.P.M."
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "OH",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norwalk, OH
- Tricia Pickett-Hoover
- Jason Michael Planthaber, QMHS
- Plastic Surgery of North Central Ohio, LLC
- Angela Jean Pocock, QMHS
- David A Pocos, D.O.
- Latasha Sherie Ponder, LCDCIII MSCJ
- Teresa Irene Porter, OTA-01110
- Michael T Powers, D.O.
- Monica Powers, LPT
- Practice Management Associates Norwalk LLC (AMC of Norwalk)
Sources for this page
- 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.