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LIBERTY DAYTON FOOT & ANKLE CENTER
NPI 1689603805
Podiatrist in Liberty, TX

Active since July 01, 2006
1825 GRAND AVE, LIBERTY, TX 77575(936) 336-2633(936) 336-6031 Get Directions Write a Review

NPPES record last updated: June 19, 2009. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Liberty Dayton Foot & Ankle Center NPPES

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

LIBERTY DAYTON FOOT & ANKLE CENTER (NPI 1689603805) is a healthcare organization registered as a podiatrist in Liberty, Texas and active in the NPI registry since July 2006. The organization lists Lawrence S Mactavish, Physician Owner, as its authorized official.

NPPES Registry Identity

NPI1689603805
Entity TypeOrganization
Primary Taxonomy213E00000X
Legal Business NameLIBERTY DAYTON FOOT & ANKLE CENTER
Location Address1825 GRAND AVELiberty, TX 77575-4705
Mailing AddressPo Box 1160Liberty, TX 77575-1160 · (281) 444-4114 · Fax (281) 453-1269
Phone(936) 336-2633
Fax(936) 336-6031
Organization SubpartNo
Authorized OfficialLawrence S MactavishPhysician Owner · (936) 336-2633
Enumeration DateJuly 1, 2006
Last NPPES UpdateJune 19, 2009
✔ NPI 1689603805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers
Taxonomy Code213E00000X
License✔ Licensed in TX · 506
Definition
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.
1825 GRAND AVE, Liberty, TX 77575
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Other Names 1

Doing Business AsLiberty Dayton Foot & Ankle Center

Other Identifiers 8

Medicare NSC0660130002TX
Medicaid199497201TX
OtherDG6815TX · Rr Medicare
Medicare PIN8K5256TX
Medicare PIN00J24PTX
Other00J24PTX · Bcbs
Medicaid121574103TX
Medicare PIN00X101TX

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Liberty Dayton Foot & Ankle Center is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Liberty Dayton Foot & Ankle Center, which bills Medicare for the services they deliver. They are listed nearest first.

Clinicians, nearest first (2)

Lawrence Mactavish, D.P.M.
Podiatry
NPI 1104858885
17215 RED OAK DR STE 102
Houston, TX 77090
(281) 444-4114
✔ PECOS✔ Accepts Medicare39 mi
Lawrence Mactavish, D.P.M.
Podiatry
NPI 1588609408
17215 RED OAK DR SUITE 102
Houston, TX 77090
(281) 444-4114
✔ PECOS✔ Accepts Medicare39 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Liberty Dayton Foot & Ankle Center's NPI number?

The NPI number for Liberty Dayton Foot & Ankle Center is 1689603805. It was assigned to this organization in the NPPES registry on July 1, 2006.

Where is Liberty Dayton Foot & Ankle Center located?

Liberty Dayton Foot & Ankle Center is located at 1825 Grand Ave, Liberty, TX 77575. The listed phone number is (936) 336-2633.

What is Liberty Dayton Foot & Ankle Center's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Is Liberty Dayton Foot & Ankle Center enrolled in Medicare?

Yes. Liberty Dayton Foot & Ankle Center is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Liberty Dayton Foot & Ankle Center?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Podiatry, reassign their Medicare billing to Liberty Dayton Foot & Ankle Center. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Liberty Dayton Foot & Ankle Center was last updated on June 19, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.