Comprehensive Podiatry Clinic, LLC – Podiatrist, NPI 1366614752

Comprehensive Podiatry Clinic, LLC is a healthcare provider. based in Stone mountain, Georgia. specializing in Podiatrist. The organization holds a License No. POD001076 (GA). The NPI Number for Comprehensive Podiatry Clinic, LLC is 1366614752

Main info

Organization
Name
Comprehensive Podiatry Clinic, LLC
NPI
1366614752
Phone
(404) 435-6389
Address
624 EL PRADO CT
Authorized Official
TONY GAYLE OWNER
Enumeration Date
26 March 2008
Last Update Date
9 July 2018
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness80
Years active:18State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Comprehensive Podiatry Clinic, LLC

  • 624, El Prado Court, Stone Mountain, DeKalb County, Georgia, 30083, United States

    STONE MOUNTAIN, GA 300833822

    Phone: (404) 435-6389

    Mailing address matches the actual address.

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: 2008-09-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2023-09-30 (983 days ago).

Enrollment records

1

Earliest due date

2023-09-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20080918000091OClinic/Group PracticeGA2023-09-30

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.

Verify on CMS Revalidation Lookup Tool

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 30083)

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Reviews

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Frequently asked questions

Does Comprehensive Podiatry Clinic, LLC have a public NPI I can cite?
Public records show Comprehensive Podiatry Clinic, LLC under NPI 1366614752.
Should I treat Comprehensive Podiatry Clinic, LLC as an active provider?
Patients and plans typically see Comprehensive Podiatry Clinic, LLC as active in the national extract.
What does the directory say Comprehensive Podiatry Clinic, LLC does?
Insurance directories may phrase it differently, but here Comprehensive Podiatry Clinic, LLC maps to Podiatrist. Clinical services aligned with this taxonomy classification.
Is Comprehensive Podiatry Clinic, LLC tied to Stone Mountain, Georgia?
If you are local to Stone Mountain, Georgia, Comprehensive Podiatry Clinic, LLC may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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