Provider Demographics
NPI:1144408543
Name:TOTAL FOOTCARE, P. C .
Entity Type:Organization
Organization Name:TOTAL FOOTCARE, P. C .
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:KAYE
Authorized Official - Last Name:GINGRICH
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:804-934-0661
Mailing Address - Street 1:5230 HICKORY PARK DR
Mailing Address - Street 2:SUITE D
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-2628
Mailing Address - Country:US
Mailing Address - Phone:804-934-0661
Mailing Address - Fax:804-934-0663
Practice Address - Street 1:5230 HICKORY PARK DR
Practice Address - Street 2:SUITE D
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-2628
Practice Address - Country:US
Practice Address - Phone:804-934-0661
Practice Address - Fax:804-934-0663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-07
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300817332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA286847OtherMAMSI
VA140045OtherANTHEM/BCBS
VA130184OtherSOUTHERN HEALTH
VA34510OtherSENTARA
VA130184OtherSOUTHERN HEALTH
VA286847OtherMAMSI