{"npi":"1376202986","type":"NPI-2","status":"active","name":{"display":"Providence Podiatry Care, INC","other":[],"organization_name":"PROVIDENCE PODIATRY CARE, INC","authorised_official":"Eddie Avila"},"specialty":{"primary_taxonomy":"213ES0103X","primary_taxonomy_description":"Foot & Ankle Surgery Podiatrist","slug":"foot-ankle-surgery-podiatrist","schema_org_specialty":null,"all":[{"code":"213ES0103X","description":"Foot & Ankle Surgery Podiatrist","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"473 E CARNEGIE DRIVE","city":"SAN BERNARDINO","state":"CA","postal_code":"92408","country_code":"US","street_2":"SUITE 200","phone":"9092447430","fax":"9094951380"},{"purpose":"MAILING","street_1":"473 E CARNEGIE DRIVE","city":"SAN BERNARDINO","state":"CA","postal_code":"92408","country_code":"US","street_2":"SUITE 200","phone":"9092447430","fax":"9094951380"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20211217002222","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"CA","pac_id":"6507256708"}]},"enumeration_date":"2021-12-10","last_updated":"2023-06-21","_meta":{"source":"NPPES","snapshot_date":"2023-06-21","doc_url":"https://findmynpi.com/api"}}