Wiregrass Podiatry LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

WIREGRASS PODIATRY LLC

Practice address

1008 Boll Weevil Cir Ste B
Enterprise, AL 36330-3400

Phone

(334) 494-8200

Fax

(334) 460-1984

NPI assigned

Dec 27, 2018

Organization subpart

No

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

Authorized official

Name

Jennifer Rose Decker, DPMNPI 1104092113

Title

Administrator

Phone

(334) 494-8200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19193/brand/1/csg/1/fhir/r4

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Rose Decker, DPM

  • Podiatrist
  • Enterprise, AL
  • NPI 1104092113
  Medicare reassignment NPD Authorized official
• Whitney Rayanne Syrus, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Troy, AL
  • NPI 1396125829
  Medicare reassignment NPD
• Robert Hannahan, MD

  • Anesthesiology Physician
  • Enterprise, AL
  • NPI 1720074818
  NPD
• Steven Charles Runkel, D.C.

  • Chiropractor
  • Dothan, AL
  • NPI 1144318593
  NPD (past)

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601251200000",
    "number": "1952873283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 BOLL WEEVIL CIR STE B",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363303400",
            "telephone_number": "334-494-8200",
            "fax_number": "334-460-1984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 BOLL WEEVIL CIR STE B",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363303400",
            "telephone_number": "334-494-8200",
            "fax_number": "334-460-1984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIREGRASS PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-27",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A",
        "authorized_official_last_name": "DECKER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "334-494-8200",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria Williams, ALC
• Jessica Lynn Williams, WHNP, CNM
• Wendy A Windham, CRNA
• Charlotte Patricia Windom, M.S.
• Wiregrass Dental Center LLC
• Nicole Wolfe, DPT
• Savannah Adora Womack, PA-C
• Joseph Trenton Wood, PHARMD
• Christina Fitzgerald Woods, LICSW
• Lorie C Woods, OD

• Podiatrist in Enterprise, AL
• Providers in Enterprise, AL by specialty
• Podiatrist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.