MEDICARE: TOTAL FOOTCARE, P. C .

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	0103300817	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	286847	OTHER	VA	MAMSI
2	140045	OTHER	VA	ANTHEM/BCBS
3	130184	OTHER	VA	SOUTHERN HEALTH
4	34510	OTHER	VA	SENTARA

General Provider Information

NPI Number	:	1144408543
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL FOOTCARE, P. C .

Provider Business Mailing Address
First Line	:	5230 HICKORY PARK DR
Second Line	:	SUITE D
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-2628
Country	:	US
Telephone Number	:	804-934-0661
Fax Number	:	804-934-0663

Provider Business Practice Location Address
First Line	:	5230 HICKORY PARK DR
Second Line	:	SUITE D
City	:	GLEN ALLEN
State	:	VA
Zip	:	23059-2628
Country	:	US
Telephone Number	:	804-934-0661
Fax Number	:	804-934-0663

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KRISTIN KAYE GINGRICH
Credential	:	DPM
Telephone Number	:	804-934-0661

Provider Enumeration Date	:	02/07/2008
Last Update Date	:	06/13/2016

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