NPIMap

Organization Active NPI

Podiatry LTD

  • Foot Surgery Podiatrist
  • Portsmouth, VA
National Provider Identifier
1972600104
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
Legal business name
PODIATRY LTD
Practice address
3511 Western Branch Blvd
Portsmouth, VA 23707-3133
Phone
(757) 399-5621
Fax
(757) 397-5889
NPI assigned
Sep 20, 2006
Last updated
Mar 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Authorized official

Name
Dr. Derba Jean Aleck, DPM
Title
Owner
Phone
(757) 399-5621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery Podiatrist 213ES0131X NU Primary

Addresses

Primary practice location

3511 Western Branch Blvd
Portsmouth, VA 23707-3133

Mailing address

3511 Western Branch Blvd
Portsmouth, VA 23707-3133
Phone (757) 399-5621

Other identifiers 1

IdentifierTypeStateIssuer
009332146MedicaidVA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1972600104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3511 WESTERN BRANCH BLVD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073133",
            "telephone_number": "757-399-5621",
            "fax_number": "757-397-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3511 WESTERN BRANCH BLVD",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237073133",
            "telephone_number": "757-399-5621",
            "fax_number": "757-397-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODIATRY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "ALECK",
        "authorized_official_first_name": "DERBA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-399-5621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009332146",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.