Vis Podiatry
Organization Active NPI Podiatrist · Perry, OH
NPI 1962088286 · NPPES record last updated Mar 18, 2021
Key facts
- NPI
- 1962088286
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Podiatrist 213E00000X
- Legal business name
- VIS PODIATRY
- Practice address
- 4056 Manchester Rd
Perry, OH 44081-8657 - Phone
- (440) 259-8120
- Fax
- (440) 259-8186
- NPI assigned
- Mar 18, 2021
- Organization subpart
- No
Authorized official
- Name
- Douglas I Vis, DPM
- Title
- Owner
- Phone
- (440) 259-8120
Practitioners 1
-
Douglas I Vis, DPM
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20210322002048 | OH | Part B Supplier - Clinic/Group Practice | 1254748114 |
Receives reassigned benefits from 1 practitioner Practice locations: Perry, OH |
National Provider Directory
Locations
486 S Main St
Andover, OH 44003
Phone (440) 293-4226
1140 S Broadway
Geneva, OH 44041
Phone (330) 929-0009
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist |
213E00000X | Yes |
Addresses
Primary practice location
4056 Manchester Rd
Perry, OH 44081-8657
Mailing address
4056 Manchester Rd
Perry, OH 44081-8657
Phone (440) 259-8120
Other providers in Perry, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.