Advanced Foot & Ankle Center LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

07000941A Issued in IN

Legal business name

ADVANCED FOOT & ANKLE CENTER LLC

Practice address

111 Boyd Cir
Michigan City, IN 46360-7016

Phone

(219) 405-3775

Fax

(219) 405-3775

NPI assigned

Feb 7, 2012

Last updated

Sep 12, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Cynthia Grundy, DPM

Title

Doctor

Phone

(219) 405-3775

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1328572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568246400000",
    "number": "1972875854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 ASPEN RD",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463681027",
            "telephone_number": "219-405-3775",
            "fax_number": "219-405-3775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BOYD CIR",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463607016",
            "telephone_number": "219-405-3775",
            "fax_number": "219-405-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FOOT & ANKLE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-07",
        "last_updated": "2019-09-12",
        "status": "A",
        "authorized_official_last_name": "GRUNDY",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "219-405-3775",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "IN",
            "license": "07000941A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2019; 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.