1629382247 NPI number — FOOT AND ANKLE SPECIALISTS OF CENTRAL OHIO, LLC

Table of content: KRISTINA JOAN COTTLE FELDMAN PHD (NPI 1427488949)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629382247 NPI number — FOOT AND ANKLE SPECIALISTS OF CENTRAL OHIO, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FOOT AND ANKLE SPECIALISTS OF CENTRAL OHIO, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1629382247
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/18/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
680 BUCKLES CT, N
Provider Second Line Business Mailing Address:
STE 2A
Provider Business Mailing Address City Name:
GAHANNA
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43230-6928
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
614-339-2000
Provider Business Mailing Address Fax Number:
614-939-9299

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
680 BUCKLES CT, N
Provider Second Line Business Practice Location Address:
STE 2A
Provider Business Practice Location Address City Name:
GAHANNA
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43230-6928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
614-339-2000
Provider Business Practice Location Address Fax Number:
614-939-9299
Provider Enumeration Date:
08/06/2010

Additional Information

Authorized Official

Authorized Official Last Name:
GURWIN
Authorized Official First Name:
SCOTT
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
OWNER PHYSICIAN
Authorized Official Telephone Number:
614-339-2000

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  OH002584 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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