Healthcare Provider Details

I. General information

NPI: 1700424769
Provider Name (Legal Business Name): INSTRIDE FOOT AND ANKLE SPECIALISTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2019
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1538 HEALTH CARE DR
ROCK HILL SC
29732-3857
US

IV. Provider business mailing address

1036 BRANCHVIEW DR STE 216
CONCORD NC
28025-0113
US

V. Phone/Fax

Practice location:
  • Phone: 803-327-1654
  • Fax: 803-283-9920
Mailing address:
  • Phone: 704-886-1918
  • Fax: 704-257-2049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number
License Number State

VIII. Authorized Official

Name: ELDON PETERS
Title or Position: VICE PRESIDENT
Credential:
Phone: 919-619-7310