MEDICARE: CLINICAL STEPS MOBILE FOOT CARE, LLC

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	163WH0200X	Home Health Registered Nurse
2	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1881527539
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICAL STEPS MOBILE FOOT CARE, LLC

Provider Business Mailing Address
First Line	:	8170 MALL PKWY # 1114
Second Line	:
City	:	LITHONIA
State	:	GA
Zip	:	30038-2545
Country	:	US
Telephone Number	:	470-747-2612
Fax Number	:

Provider Business Practice Location Address
First Line	:	5734 WIND GATE LN
Second Line	:
City	:	LITHONIA
State	:	GA
Zip	:	30058-2601
Country	:	US
Telephone Number	:	470-747-2612
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MARSHA JACKSON
Credential	:	RN,BSN,FOOT CARE NUR
Telephone Number	:	470-747-2612

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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