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GRAND LAKE PODIATRY INC
NPI 1184896383
Podiatrist - Foot & Ankle Surgery in Bellefontaine, OH

Active since March 27, 2008
3772 US RT 68 S, BELLEFONTAINE, OH 43311(937) 599-3668(937) 599-4852 Get Directions Write a Review

NPPES record last updated: June 9, 2011. Verified against the NPPES registry weekly; last sync: August 09, 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 1184896383) is a healthcare organization registered as a foot & ankle surgery in Bellefontaine, 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

NPI1184896383
Entity TypeOrganization
Primary Taxonomy213ES0103X
Legal Business NameGRAND LAKE PODIATRY INC
Location Address3772 US RT 68 SBellefontaine, OH 43311-3311
Mailing Address1222 Irmscher BlvdCelina, OH 45822-8305 · (419) 586-7874 · Fax (419) 586-2776
Phone(937) 599-3668
Fax(937) 599-4852
Organization SubpartNo
Authorized OfficialMary Katherine Benjamin-swongerPodiatrist/owner-president · (419) 586-7874
Enumeration DateMarch 27, 2008
Last NPPES UpdateJune 9, 2011
✔ NPI 1184896383 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
3772 US RT 68 S, Bellefontaine, OH 43311
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Other Identifiers 4

Medicare NSC1153470008
Medicare PIN9285765OH
Medicaid2544858OH
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 1184896383. 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 3772 Us Rt 68 S, Bellefontaine, OH 43311. The listed phone number is (937) 599-3668.

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.