STEP UP PODIATRY PROFESSIONAL CORPORATION NPI 1902280928

Podiatrist (Foot & Ankle Surgery) in Rohnert Park, CA

NPI 1902280928 Organization Podiatrist Foot & Ankle Surgery

About STEP UP PODIATRY PROFESSIONAL CORPORATION

Step Up Podiatry Professional Corporation is a provider established in Rohnert Park, California specializing in podiatrist (foot & ankle surgery) . The NPI number of Step Up Podiatry Professional Corporation is 1902280928 and was assigned on July 2015. The practitioner's primary taxonomy code is 213ES0103X with license number E34090 (CA). The provider is registered as an organization and their NPI record was last updated 7 years ago. Step Up Podiatry Professional Corporation operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Thomas Michael Fitzgerald Dpm (Owner)

NPI

1902280928

Provider NameSTEP UP PODIATRY PROFESSIONAL CORPORATION
Provider Location Address1350 MEDICAL CENTER DR STE B ROHNERT PARK, CA 94928
Provider Mailing Address1350 MEDICAL CENTER DR STE B ROHNERT PARK, CA 94928
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date07-20-2015
Last Update Date07-20-2015


Primary Taxonomy

Taxonomy Code213ES0103X
ClassificationPodiatrist
TypePodiatric Medicine & Surgery Service Providers
SpecializationFoot & Ankle Surgery
License No.E34090
License StateCA

Business Address

STEP UP PODIATRY PROFESSIONAL CORPORATION
1350 MEDICAL CENTER DR
STE B
ROHNERT PARK, CA
ZIP 94928
Phone: (707) 586-9300

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Mailing Address

STEP UP PODIATRY PROFESSIONAL CORPORATION
1350 MEDICAL CENTER DR
STE B
ROHNERT PARK, CA
ZIP 94928
Phone: (707) 586-9300



Authorized Official

Authorized Official NameDR. THOMAS MICHAEL FITZGERALD DPM
Authorized Official TitleOWNER
Authorized Official Phone(707) 586-9300

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Other Providers at the same location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1043506140DR. AMEHA TEKLU JOBA DPM
Individual
Podiatrist (Foot & Ankle Surgery)1350 MEDICAL CENTER DR STE B
ROHNERT PARK, CA 94928
(707) 586-9300
1730683418AMEHA T. JOBA,DPM, PC
Organization
Podiatrist (Foot & Ankle Surgery)1350 MEDICAL CENTER DR
ROHNERT PARK, CA 94928
(707) 586-9300

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.