Betha Hunnicutt Ertzberger, CPED

Primary specialty

PedorthistTaxonomy code 224L00000X

Practice address

2905 Veterans Memorial Hwy Ste 2
Ronkonkoma, NY 11779-7655

Phone

(631) 619-8505

NPI assigned

Aug 31, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1992287387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 ARMSTRONG PARK DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544889",
            "telephone_number": "704-747-6579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 VETERANS MEMORIAL HWY STE 2",
            "city": "RONKONKOMA",
            "state": "NY",
            "postal_code": "117797655",
            "telephone_number": "631-619-8505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERTZBERGER",
        "first_name": "BETHA",
        "middle_name": "HUNNICUTT",
        "credential": "CPED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224L00000X",
            "taxonomy_group": "",
            "desc": "Pedorthist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pedorthist in Ronkonkoma, NY
• Providers in Ronkonkoma, NY by specialty
• Pedorthist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.