NPIMap

Organization Active NPI

Associated Foot and Ankle Specialists of Ohio Inc

  • Podiatrist
  • Dayton, OH
National Provider Identifier
1962847590
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
36003238 Issued in OH
Legal business name
ASSOCIATED FOOT AND ANKLE SPECIALISTS OF OHIO INC
Practice address
8721 N Main St
Dayton, OH 45415-1331
Phone
(937) 264-3150
NPI assigned
May 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Authorized official

Name
Lisa Nicely, DPM
Title
Owner
Phone
(937) 293-8448

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 36003238 OH Primary

Addresses

Primary practice location

8721 N Main St
Dayton, OH 45415-1331

Mailing address

6200 Pleasant Ave
Suite 3
Fairfield, OH 45014-4670
Phone (513) 829-9333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130814001044 OH DME Supplier - Physician - Podiatry 5799719613 Practice locations: Dayton, OH

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Associated Foot and Ankle Specialists of Ohio Inc6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

8721 N Main St
Dayton, OH 45415
Phone (937) 223-7106

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1962847590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 PLEASANT AVE",
            "address_2": "SUITE 3",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450144670",
            "telephone_number": "513-829-9333",
            "fax_number": "513-858-7827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8721 N MAIN ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151331",
            "telephone_number": "937-264-3150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED FOOT AND ANKLE SPECIALISTS OF OHIO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-09",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "NICELY",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-293-8448",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "OH",
            "license": "36003238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.