Organization Active NPI

Watkins Foot and Ankle Clinic LLC

  • Foot & Ankle Surgery Podiatrist
  • Leesburg, FL
National Provider Identifier
1982146346
Registry record updated Oct 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO2769 Issued in FL
Legal business name
WATKINS FOOT AND ANKLE CLINIC LLC
Practice address
914 E Dixie Ave
Leesburg, FL 34748-7647
Phone
(352) 805-4317
Fax
(352) 805-4298
NPI assigned
Nov 16, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2018

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

Authorized official

Name
Dr. Chad C Watkins, D.P.M.NPI 1174514194
Title
Ceo
Phone
(352) 805-4317

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 PO2769 FL Primary

Addresses

Primary practice location

914 E Dixie Ave
Leesburg, FL 34748-7647

Mailing address

914 E Dixie Ave
Leesburg, FL 34748-7647
Phone (352) 805-4317

Other identifiers 2

IdentifierTypeStateIssuer
390469500MedicaidFL
1174514194OtherFLNPI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170118001967 FL Part B Supplier - Clinic/Group Practice 0143502682 Receives reassigned benefits from 1 practitioner
Practice locations: Leesburg, FL

National Provider Directory

National Provider Directory

Locations

914 E Dixie Ave
Leesburg, FL 34748
Phone (352) 343-9025

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/15111/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

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": "1479254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538352000000",
    "number": "1982146346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "914 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487647",
            "telephone_number": "352-805-4317",
            "fax_number": "352-805-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 E DIXIE AVE",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347487647",
            "telephone_number": "352-805-4317",
            "fax_number": "352-805-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATKINS FOOT AND ANKLE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-16",
        "last_updated": "2018-10-01",
        "status": "A",
        "authorized_official_last_name": "WATKINS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "352-805-4317",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO2769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390469500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1174514194",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; 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.