NPI age
6 years
Enumerated 2019-10-04
● Active Type 2 · Organization
Modern Podiatry, Llc
Modern Podiatry, Llc is 1 of 45 clinic/center organizations in Georgia.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Wanzu
Owner
Last NPPES update
2024-05-13
Source: monthly bulk 2026-05
How this organization compares
Across 45 active clinic/center providers in Georgia.
NPI age
6 years
↓ 4 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2019 → 2026
2019-10Enumerated in NPPES
2019
2026
Where they practice
Primary practice location
366 Racetrack Rd
McDonough, GA 302521022
Mailing address
1270 Highway 314
Fayetteville, GA 302145449
Authorized official
Kibibi Wanzu, DPM
Owner
📞 4707815585
Individual providers at this organization
3 individual providers on file at this primary practice address.
- Ronald Patrick, M.D. Surgery NPI 1679559728
- Brittany Sumpter, DPM Podiatrist NPI 1992188759
- Kibibi Wanzu Podiatrist NPI 1043689623
Specialties
-
Clinic/Center PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003233587A |
Practice context
Multi-provider organization. 3 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.