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ACTIVE ANKLE & FOOT CARE SPECIALIST NPI 1831575034


NPI Information

NPI: 1831575034
Provider Name: ACTIVE ANKLE & FOOT CARE SPECIALIST
Classification: Preferred Provider Organization - 305R00000X
Entity Type: Organization
Address:
6335 HOSPITAL PARKWAY
SUITE 305
JOHNS CREEK, GA
ZIP 30097
Phone: (404) 373-7004
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ACTIVE ANKLE & FOOT CARE SPECIALIST is a preferred provider organization in Johns Creek, GA. The provider is a group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. ACTIVE ANKLE & FOOT CARE SPECIALIST NPI is 1831575034. The provider is registered as an organization entity type.

The provider's business location address is:

6335 HOSPITAL PARKWAY
SUITE 305
JOHNS CREEK, GA
ZIP 30097-712
Phone: (404) 373-7004
Fax: (404) 373-7008

The provider's authorized official is Ingie M El-khashab .
The authorized official title is Owner/physician and has the following contact phone number (404) 373-7004.

The enumeration date for this NPI number is 8/11/2015 and was last updated on 8/11/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1305R00000XPreferred Provider OrganizationGEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1511I480043MEDICARE PINGEORGIA
26139410001MEDICARE NSCGEORGIA
3V05923MEDICARE UPINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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