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GRAND LAKE PODIATRY INC
NPI 1871765362
Podiatrist - Foot & Ankle Surgery in Celina, OH

Active since March 25, 2008
1222 IRMSCHER BLVD, CELINA, OH 45822(419) 586-7874(419) 586-2776 Get Directions Write a Review

NPPES record last updated: June 14, 2011. Verified against the NPPES registry weekly; last sync: August 16, 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 1871765362) is a healthcare organization registered as a foot & ankle surgery in Celina, Ohio and active in the NPI registry since March 2008. The organization lists Mary Katherine Swonger, Podiatrist/owner-president, as its authorized official.

NPPES Registry Identity

NPI1871765362
Entity TypeOrganization
Primary Taxonomy213ES0103X
Legal Business NameGRAND LAKE PODIATRY INC
Location Address1222 IRMSCHER BLVDCelina, OH 45822-8305
Mailing Address1222 Irmscher BlvdCelina, OH 45822-8305 · (419) 586-7874 · Fax (419) 586-2776
Phone(419) 586-7874
Fax(419) 586-2776
Organization SubpartNo
Authorized OfficialMary Katherine SwongerPodiatrist/owner-president · 41958687874
Enumeration DateMarch 25, 2008
Last NPPES UpdateJune 14, 2011
✔ NPI 1871765362 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
1222 IRMSCHER BLVD, Celina, OH 45822
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Other Identifiers 4

Medicaid2056313OH
Medicare NSC1153470001
Medicare PIN9285762OH
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

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

GRAND LAKE FOOT & ANKLE INC
Podiatrist
1222 IRMSCHER BLVD
CELINA, OH 45822
Mercer County (419) 586-7874

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 1871765362. It was assigned to this organization in the NPPES registry on March 25, 2008.

Where is Grand Lake Podiatry Inc located?

Grand Lake Podiatry Inc is located at 1222 Irmscher Blvd, Celina, OH 45822. The listed phone number is (419) 586-7874.

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 14, 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.