Provider Demographics
NPI:1003914698
Name:HARRISONBURG FOOT & ANKLE CLINIC, PC
Entity Type:Organization
Organization Name:HARRISONBURG FOOT & ANKLE CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-434-2949
Mailing Address - Street 1:PO BOX 1314
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1314
Mailing Address - Country:US
Mailing Address - Phone:540-434-2949
Mailing Address - Fax:540-433-8870
Practice Address - Street 1:2105 EVELYN BYRD AVE
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-5431
Practice Address - Country:US
Practice Address - Phone:540-434-2949
Practice Address - Fax:540-433-8870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA213EP1101X
VA0103000324213ES0103X
VA0103300821213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1003914698Medicaid
VA1003914698OtherGROUP NPI
VA1003914698Medicaid
VA0954270001Medicare NSC
VAC04632Medicare PIN