MEDICARE: INSTRIDE FOOT AND ANKLE SPECIALISTS, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	213ES0103X	Foot & Ankle Surgery Podiatrist
2	213ES0131X	Foot Surgery Podiatrist
3	213EP1101X	Primary Podiatric Medicine Podiatrist

General Provider Information

NPI Number	:	1720696834
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSTRIDE FOOT AND ANKLE SPECIALISTS, PLLC

Provider Business Mailing Address
First Line	:	1036 BRANCHVIEW DR STE 216
Second Line	:
City	:	CONCORD
State	:	NC
Zip	:	28025-0113
Country	:	US
Telephone Number	:	704-886-1918
Fax Number	:	704-257-2049

Provider Business Practice Location Address
First Line	:	6341 COOK AVE STE A
Second Line	:
City	:	CLEMMONS
State	:	NC
Zip	:	27012-9380
Country	:	US
Telephone Number	:	336-766-8400
Fax Number	:

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	ELDON PETERS
Credential	:
Telephone Number	:	919-829-0076

Provider Enumeration Date	:	07/15/2020
Last Update Date	:	10/09/2025

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