Avon Lake Podiatry Inc

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

36.002416 Issued in OH

Legal business name

AVON LAKE PODIATRY INC

Practice address

32730 Walker Rd
Suite I-3
Avon Lake, OH 44012-4100

Phone

(440) 933-4021

Fax

(440) 933-7132

NPI assigned

Dec 8, 2006

Last updated

May 29, 2008By 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

Dr. Mark David Gould, DPMNPI 1740257302

Title

President

Phone

(440) 933-4021

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 1

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.

• Mark David Gould, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Avon Lake, OH
  • NPI 1740257302
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1992864490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32730 WALKER RD",
            "address_2": "SUITE I-3",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440124100",
            "telephone_number": "440-933-4021",
            "fax_number": "440-933-7132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32730 WALKER RD",
            "address_2": "SUITE I-3",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440124100",
            "telephone_number": "440-933-4021",
            "fax_number": "440-933-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVON LAKE PODIATRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "GOULD",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-933-4021",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36.002416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Avon Lake Back & Neck, Inc.
• Avon Lake City Schools
• Hannah M Bacon, LSW
• Darlene Baron, RPH
• Claudia Kay Bevan, D.D.S.
• Amber Biacsi, RN
• Mariah Jordan Big, PMHNP-BC

• Foot & Ankle Surgery Podiatrist in Avon Lake, OH
• Providers in Avon Lake, OH by specialty
• Foot & Ankle Surgery Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2008; 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.