NPIMap

Organization Active NPI

Bangor Podiatry LLC

  • Foot & Ankle Surgery Podiatrist
  • Gilbert, PA
National Provider Identifier
1972996189
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
SC004468L Issued in PA
Legal business name
BANGOR PODIATRY LLC
Practice address
1310 Route 209 Ste 107
Gilbert, PA 18331-7751
Phone
(570) 992-5779
Fax
(570) 992-5806
NPI assigned
Mar 12, 2015
Last updated
Nov 15, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BANGOR PODIATRY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Authorized official

Name
Cheralyn Perkins, DPMNPI 1053400804
Title
Owner
Phone
(610) 588-6621

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 Podiatrist 213ES0103X SC004468L PA Primary

Addresses

Primary practice location

1310 Route 209 Ste 107
Gilbert, PA 18331-7751

Mailing address

129 N 11TH St
Bangor, PA 18013-1603
Phone (610) 588-6621

Other names 1

  • Bangor Podiatry of Brodheadsville Other name

National Provider Directory

National Provider Directory
Part of
Bangor Podiatry LLC

Locations

129 N 11th St
Bangor, PA 18013
Phone (610) 588-6621

224 Nazareth Pike
Unit 10
Bethlehem, PA 18020

1636 Route 209
Unit 1
Brodheadsville, PA 18322
Phone (570) 992-5779

1337 Blue Valley Dr
Ste 2
Pen Argyl, PA 18072

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731628800000",
    "number": "1972996189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 N 11TH ST",
            "city": "BANGOR",
            "state": "PA",
            "postal_code": "180131603",
            "telephone_number": "610-588-6621",
            "fax_number": "610-588-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 ROUTE 209 STE 107",
            "city": "GILBERT",
            "state": "PA",
            "postal_code": "183317751",
            "telephone_number": "570-992-5779",
            "fax_number": "570-992-5806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANGOR PODIATRY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BANGOR PODIATRY LLC",
        "enumeration_date": "2015-03-12",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "PERKINS",
        "authorized_official_first_name": "CHERALYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-588-6621",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "PA",
            "license": "SC004468L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bangor Podiatry of Brodheadsville",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gilbert, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.