MODERN PODIATRY, LLC
NPI 1811538390
Clinic/Center - Podiatric in Mcdonough, GA

Active since October 04, 2019
366 RACETRACK RD, MCDONOUGH, GA 30252(470) 781-5585 Get Directions Write a Review

NPPES record last updated: May 13, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 13, 2024, Jul 2, 2020, Oct 4, 2019 (3 updates tracked since 2019).

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

NPI1811538390
Entity TypeOrganization
Primary Taxonomy261QP1100X
Legal Business NameMODERN PODIATRY, LLC
Location Address366 RACETRACK RDMcdonough, GA 30252-1022
Mailing Address1270 Highway 314Fayetteville, GA 30214-5449 · (813) 300-4449
Organization SubpartNo
Authorized OfficialKibibi WanzuOwner · (470) 781-5585
Enumeration DateOctober 4, 2019
Last NPPES UpdateMay 13, 20243 updates tracked since enumeration
NPPES CertifiedMay 13, 2024
NPI 1811538390 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · PodiatricAmbulatory Health Care Facilities
Taxonomy Code261QP1100X
366 RACETRACK RD, Mcdonough, GA 30252

Other Identifiers 1

Medicaid003233587AGA

Accepted Insurance

Other Providers at the Same Location NPPES 4

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

Podiatrist (Foot & Ankle Surgery)
366 RACETRACK RD
MCDONOUGH, GA 30252
Surgery
366 RACETRACK RD
MCDONOUGH, GA 30252
Surgery
366 RACETRACK RD
MCDONOUGH, GA 30252
Podiatrist (Foot & Ankle Surgery)
366 RACETRACK RD
MCDONOUGH, GA 30252

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.

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 with the weekly NPPES data releases published by CMS.