GRAND LAKE PODIATRY, INC
NPI 1164694428
Podiatrist - Foot & Ankle Surgery in Minster, OH

Q: What is Grand Lake Podiatry, Inc's NPI number?

The NPI number for Grand Lake Podiatry, Inc is 1164694428. It was assigned to this organization in the NPPES registry on March 27, 2008.

Q: What is Grand Lake Podiatry, Inc's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

Active since March 27, 2008

6 EAGLE DR, MINSTER, OH 45865(419) 628-7874(419) 628-4620 Get Directions Write a Review

NPPES record last updated: April 18, 2008. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Grand Lake Podiatry, Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRAND LAKE PODIATRY, INC (NPI 1164694428) is a healthcare organization registered as a foot & ankle surgery in Minster, Ohio and active in the NPI registry since March 2008. The organization lists Mary Katherine Benjamin-swonger, Podiatrist/owner-president, as its authorized official.

NPPES Registry Identity

NPI1164694428

Entity TypeOrganization

Primary Taxonomy213ES0103X

Legal Business NameGRAND LAKE PODIATRY, INC

Location Address6 EAGLE DRMinster, OH 45865-9714

Mailing Address1222 Irmscher BlvdCelina, OH 45822-8305 · (419) 586-7874 · Fax (419) 586-2776

Phone(419) 628-7874

Fax(419) 628-4620

Organization SubpartNo

Authorized OfficialMary Katherine Benjamin-swongerPodiatrist/owner-president · (419) 586-7874

Enumeration DateMarch 27, 2008

Last NPPES UpdateApril 18, 2008

✔ NPI 1164694428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatrist · Foot & Ankle SurgeryPodiatric Medicine & Surgery Service Providers

Taxonomy Code213ES0103X

License✔ Licensed in OH · 36 002772

6 EAGLE DR, Minster, OH 45865

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Other Identifiers 4

Medicare NSC1153470006

Medicaid2544876OH

Medicare PIN9285763OH

Medicare PINCG6681

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grand Lake Podiatry, Inc's NPI number?

The NPI number for Grand Lake Podiatry, Inc is 1164694428. It was assigned to this organization in the NPPES registry on March 27, 2008.

Where is Grand Lake Podiatry, Inc located?

Grand Lake Podiatry, Inc is located at 6 Eagle Dr, Minster, OH 45865. The listed phone number is (419) 628-7874.

What is Grand Lake Podiatry, Inc's specialty?

The primary specialty registered for this NPI is Podiatrist, specializing in Foot & Ankle Surgery, with taxonomy code 213ES0103X.

When was this NPI record last updated?

The NPPES record for Grand Lake Podiatry, Inc was last updated on April 18, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.