Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jack Enoch Madsen IV, DPM

Individual provider Podiatrist · NPI 1780943043

Mr. Jack Enoch Madsen IV, DPM is a Podiatry in Atlanta, Georgia. Qualified in 2012, 14 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
14
Licensed in
GA
In the registry since
2012
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

5445 Meridian Mark Rd Ste 390
Atlanta, GA 30342-4763
Phone: (404) 237-3668
Fax: (404) 237-9563
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence POD001281 (GA)

Record details

NPI number1780943043
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorNo
NPI enumeratedMay 8, 2012
Last updated in NPPESFebruary 10, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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