Organization Active NPI

Complete Foot Care Associates

  • Foot & Ankle Surgery Podiatrist
  • Port Orange, FL
National Provider Identifier
1972903508
Registry record updated Sep 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO3320 Issued in FL
Legal business name
COMPLETE FOOT CARE ASSOCIATES
Practice address
5535 S Williamson Blvd
Suite 727
Port Orange, FL 32128-8311
Phone
(386) 506-8701
Fax
(386) 333-6456
NPI assigned
Sep 2, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2014

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

Authorized official

Name
Roger L Zema, DPMNPI 1346221306
Title
President
Phone
(386) 506-8701

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X PO3320 FL Primary

Addresses

Primary practice location

5535 S Williamson Blvd
Suite 727
Port Orange, FL 32128-8311

Mailing address

6487 Justin CT
Port Orange, FL 32128-7339
Phone (386) 506-8701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20141118001172 FL Part B Supplier - Clinic/Group Practice 2668694142 Receives reassigned benefits from 2 practitioners
Practice locations: Port Orange, FL
O20150604002261 FL DME Supplier - Physician - Podiatry 2668694142 Practice locations: Port Orange, FL

National Provider Directory

National Provider Directory

Locations

5535 S Williamson Blvd
Ste 727
Port Orange, FL 32128
Phone (386) 506-8701

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JEBJCA

Practitioners & affiliated clinicians

Practitioners 2

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": "1409616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410307200000",
    "number": "1972903508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6487 JUSTIN CT",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321287339",
            "telephone_number": "386-506-8701",
            "fax_number": "386-333-6456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 S WILLIAMSON BLVD",
            "address_2": "SUITE 727",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321288311",
            "telephone_number": "386-506-8701",
            "fax_number": "386-333-6456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE FOOT CARE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-02",
        "last_updated": "2014-09-10",
        "status": "A",
        "authorized_official_last_name": "ZEMA",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-506-8701",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO3320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2014; 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.