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GRAND LAKE PODIATRY INC
NPI 1184896177
Podiatrist - Foot & Ankle Surgery in Springfield, OH

Active since March 31, 2008
2624 LEXINGTON AVE, SPRINGFIELD, OH 45505(937) 322-3346(937) 322-3348 Get Directions Write a Review

NPPES record last updated: June 9, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Grand Lake Podiatry Inc NPPES

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

GRAND LAKE PODIATRY INC (NPI 1184896177) is a healthcare organization registered as a foot & ankle surgery in Springfield, 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

NPI1184896177
Entity TypeOrganization
Primary Taxonomy213ES0103X
Legal Business NameGRAND LAKE PODIATRY INC
Location Address2624 LEXINGTON AVESpringfield, OH 45505-2607
Mailing Address1222 Irmscher BlvdCelina, OH 45822-8305 · (419) 586-7874 · Fax (419) 586-2776
Phone(937) 322-3346
Fax(937) 322-3348
Organization SubpartNo
Authorized OfficialMary Katherine Benjamin-swongerPodiatrist/owner-president · (419) 586-7874
Enumeration DateMarch 31, 2008
Last NPPES UpdateJune 9, 2011
✔ NPI 1184896177 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
2624 LEXINGTON AVE, Springfield, OH 45505
Open in Google Maps ↗

Other Identifiers 4

Medicare PIN9285766OH
Medicaid2544885OH
Medicare NSC1153470007
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

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ERICK L BISHOP
Case Manager/Care Coordinator
2624 LEXINGTON AVE
SPRINGFIELD, OH 45505
Clark County (937) 328-5300
ERIC J LEE
Case Manager/Care Coordinator
2624 LEXINGTON AVE
SPRINGFIELD, OH 45505
Clark County (937) 328-5300
MCKINLEY HALL, INC.
Clinic/Center (Rehabilitation, Substance Use Disorder)
2624 LEXINGTON AVE
SPRINGFIELD, OH 45505
Clark County (937) 328-5300
MALINDA BOTKIN
Counselor (Addiction (Substance Use Disorder))
2624 LEXINGTON AVE
SPRINGFIELD, OH 45505
Clark County (937) 328-5300
BRANDON NAWMAN
Case Manager/Care Coordinator
2624 LEXINGTON AVE
SPRINGFIELD, OH 45505
Clark County (937) 328-5300
KEIONDRA D SWIFT
Counselor (Addiction (Substance Use Disorder))
2624 LEXINGTON AVE
SPRINGFIELD, OH 45505
Clark County (937) 328-5300
WILLARD D DEARMOND JR.
Social Worker
2624 LEXINGTON AVE
SPRINGFIELD, OH 45505
Clark County (937) 328-5300
KAITLYN ELIZABETH LEE
Case Manager/Care Coordinator
2624 LEXINGTON AVE
SPRINGFIELD, OH 45505
Clark County (937) 328-5300

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 1184896177. It was assigned to this organization in the NPPES registry on March 31, 2008.

Where is Grand Lake Podiatry Inc located?

Grand Lake Podiatry Inc is located at 2624 Lexington Ave, Springfield, OH 45505. The listed phone number is (937) 322-3346.

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 June 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.