GEORGIA PODIATRY, INC – Podiatrist, NPI 1215220090
Podiatrist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for GEORGIA PODIATRY, INC
1025 E Freeway Dr SE
Conyers, GA 300945965
Phone: (770) 929-3338
Type: Location
1599 Mulkey Rd
Austell, GA 301061111
Phone: (678) 505-8064
Fax: (678) 909-5967
Type: Location
5205 STILESBORO RD.
SUITE 205
KENNESAW, GA 301527760
Phone: (678) 310-0540
Fax: (678) 310-0538
Type: Mailing
5205 STILESBORO RD NW STE 205
KENNESAW, GA 301527765
Phone: (678) 310-0540
Fax: (678) 310-0538
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-01-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-05-31 (740 days ago).
Enrollment records
2
Earliest due date
2024-05-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20110727000480 | O | Clinic/Group Practice | GA | 2024-05-31 |
| O20120111000493 | O | Physician - Podiatry | GA | 2024-06-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30094)
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