Provider Demographics
NPI:1740458694
Name:GREEN FOOT & ANKLE CARE, LLC
Entity type:Organization
Organization Name:GREEN FOOT & ANKLE CARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:
Authorized Official - First Name:W.JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHOEPPNER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:330-899-9160
Mailing Address - Street 1:3333 MASSILLON RD STE 203
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-5992
Mailing Address - Country:US
Mailing Address - Phone:330-899-9160
Mailing Address - Fax:330-899-9170
Practice Address - Street 1:3333 MASSILLON RD
Practice Address - Street 2:SUITE 203
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5981
Practice Address - Country:US
Practice Address - Phone:330-899-9160
Practice Address - Fax:330-899-9170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36-00-2970-S332B00000X
OH36002970S213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5603640001Medicare NSC