Organization Active NPI

Uwharrie Podiatry, LLC

  • Podiatric Clinic/Center
  • Albemarle, NC
National Provider Identifier
1962673640
Registry record updated Jun 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
License
139 Issued in NC
Legal business name
UWHARRIE PODIATRY, LLC
Practice address
143 N 3Rd St
Albemarle, NC 28001-4901
Phone
(704) 983-5763
Fax
(704) 983-5642
NPI assigned
Mar 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2018

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

Authorized official

Name
Dr. Colin Lee Moffett, DPM
Title
Owner/Doctor
Phone
(704) 983-5763

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X 139 NC Primary

Addresses

Primary practice location

143 N 3Rd St
Albemarle, NC 28001-4901

Mailing address

143 N 3Rd St
Albemarle, NC 28001-4901
Phone (704) 983-5763

Other identifiers 3

IdentifierTypeStateIssuer
08125OtherNCBCBS
243063COtherNCPTAN
8908125MedicaidNC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1962673640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 N 3RD ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280014901",
            "telephone_number": "704-983-5763",
            "fax_number": "704-983-5642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 N 3RD ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280014901",
            "telephone_number": "704-983-5763",
            "fax_number": "704-983-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UWHARRIE PODIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "MOFFETT",
        "authorized_official_first_name": "COLIN",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/DOCTOR",
        "authorized_official_telephone_number": "704-983-5763",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NC",
            "license": "139",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "08125",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "243063C",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908125",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albemarle, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.