NPIMap

Organization Active NPI

Indian River Foot & Ankle, PA

  • Foot & Ankle Surgery Podiatrist
  • Sebastian, FL
National Provider Identifier
1942390182
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
INDIAN RIVER FOOT & ANKLE, PA
Practice address
1424 US Highway 1
Suite a
Sebastian, FL 32958-1619
Phone
(772) 589-3110
Fax
(772) 388-1929
NPI assigned
Oct 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

Authorized official

Name
Dr. David J Haile, DPM
Title
Owner
Phone
(772) 589-3110

Specialties & licenses 1

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

Addresses

Primary practice location

1424 US Highway 1
Suite a
Sebastian, FL 32958-1619

Mailing address

1424 US Highway 1
Suite a
Sebastian, FL 32958-1619
Phone (772) 589-3110

Other identifiers 1

IdentifierTypeStateIssuer
390266800MedicaidFL

National Provider Directory

National Provider Directory

Locations

1424 US Highway 1
#650
Sebastian, FL 32958

1424 US Highway 1
Ste 5
Sebastian, FL 32958

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207008000000",
    "number": "1942390182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1424 US HIGHWAY 1",
            "address_2": "SUITE A",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329581619",
            "telephone_number": "772-589-3110",
            "fax_number": "772-388-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 US HIGHWAY 1",
            "address_2": "SUITE A",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329581619",
            "telephone_number": "772-589-3110",
            "fax_number": "772-388-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIAN RIVER FOOT & ANKLE, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2008-04-01",
        "status": "A",
        "authorized_official_last_name": "HAILE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "772-589-3110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390266800",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.