MODERN PODIATRY, LLC
NPI 1811538390
Clinic/Center - Podiatric in Mcdonough, GA
About Modern Podiatry, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MODERN PODIATRY, LLC (NPI 1811538390) is a healthcare organization registered as a podiatric in Mcdonough, Georgia and active in the NPI registry since October 2019. The organization lists Kibibi Wanzu, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Modern Podiatry, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Modern Podiatry, LLC, which bills Medicare for the services they deliver. Of these, 2 practice within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
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 Modern Podiatry, LLC's NPI number?
The NPI number for Modern Podiatry, LLC is 1811538390. It was assigned to this organization in the NPPES registry on October 4, 2019.
Where is Modern Podiatry, LLC located?
Modern Podiatry, LLC is located at 366 Racetrack Rd, Mcdonough, GA 30252. The listed phone number is (470) 781-5585.
What is Modern Podiatry, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Podiatric, with taxonomy code 261QP1100X.
Is Modern Podiatry, LLC enrolled in Medicare?
Yes. Modern Podiatry, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Modern Podiatry, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians, all in Podiatry, reassign their Medicare billing to Modern Podiatry, LLC. 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. Of these, 2 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Modern Podiatry, LLC accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Modern Podiatry, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Modern Podiatry, LLC was last updated on May 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Modern Podiatry, Llc · NPI 1811538390
Podiatric organization in Mcdonough, Georgia. Organization record, active in the CMS NPPES registry since October 4, 2019.
## Identity
- **NPI:** 1811538390 (Entity type: Organization)
- **Enumerated:** October 4, 2019
- **Primary specialty:** Clinic/Center - Podiatric · taxonomy 261QP1100X
- **Organization subpart:** No
- **Authorized official:** Kibibi Wanzu, OWNER
## Practice location
- **Address:** 366 RACETRACK RD, Mcdonough, GA 30252-1022
- **Phone:** (470) 781-5585
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians (Podiatry) reassign Medicare billing to this organization (form CMS-855R); 2 practice within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 13, 2024
- **Other identifiers:** Medicaid 003233587A (GA)
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Source: [NPI Profile](https://npiprofile.com/npi/1811538390) · Data from the CMS NPPES public registry.