Provider Demographics
NPI:1831369578
Name:CAPITAL FOOT CARE PC
Entity type:Organization
Organization Name:CAPITAL FOOT CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:SHADBOLT
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:804-754-7400
Mailing Address - Street 1:2200 PUMP RD STE 227
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23233-3539
Mailing Address - Country:US
Mailing Address - Phone:804-754-7400
Mailing Address - Fax:804-754-7402
Practice Address - Street 1:2200 PUMP RD STE 227
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23233
Practice Address - Country:US
Practice Address - Phone:804-754-7400
Practice Address - Fax:804-754-7402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-10
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA4984950001Medicare NSC
VAC09026Medicare PIN