Form 6 Accreditation

the

DataBank

DCN: 5950000090960758
Process Date: 11/26/2014
Page: 1
of
2
FOOTCAREINC
For authorized use by:
ASHI

P.O. Box 10832
Chantilly, VA 20153-0832
http://www.npdb.hrsa.gov

FOOTCAREINC
ASHI
ACCREDITATION ACTION

Date of Action: 11/26/2014

Initial Action
- ACCREDITATION TERMINATED

A. REPORTING
ENTITY

Entity Name:
Address:
City, State, Zip:
Country:
Name or Office:
Title or Department:
Telephone:
Entity Internal Report Reference:
Type of Report:

Organization Name:
Other Organization Name(s) Used:
Business Address:
City, State, ZIP:
Organization Type:
Names and Titles of Principal Officers and Owners (POO):
Federal Employer Identification Numbers (FEIN):
Social Security Numbers (SSN):
State License Number, State of Licensure:
Drug Enforcement Administration (DEA) Numbers:
Clinical Laboratory Act (CLIA) Numbers:
Food and Drug Administration (FDA) Numbers:
National Provider Identifiers (NPI):
Medicare Provider/Supplier Numbers:
Name(s) of Health Care Entity (Entities) With Which Subject Is
Affiliated or Associated (Inclusion Does Not Imply Complicity in
the Reported Action.):
Business Address of Affiliate:
City, State, ZIP:
Nature of Relationship(s):

B. SUBJECT
IDENTIFICATION
INFORMATION
(ORGANIZATION)

C. INFORMATION
REPORTED

Basis for Initial Action
- NONCOMPLIANCE WITH PRIVATE ACCREDITATION
STANDARDS THAT INDICATE A RISK TO THE SAFETY OF
PATIENT(S) OR QUALITY OF HEALTH CARE SERVICES
ASHI
1716 FIELD AVENUE
ST. PAUL, MN 55116
MELISSA WEEKS
ACCREDITATION MANAGER
(651) 202-3637
INITIAL
FOOTCAREINC
5600 FISHERS LN
ROCKVILLE, MD 20852-1750
CHIROPRACTIC GROUP/PRACTICE (361)
MANN, ANITTA
111111111
MD89, MD

7777777

FOOTCAREINC2
5600 FISHERS LN
ROCKVILLE, MD 20852-1750
SUBJECT IS CONTRACTOR TO AFFILIATE OR ASSOCIATE (250)

Type of Adverse Action: ACCREDITATION
Basis for Action: NONCOMPLIANCE WITH PRIVATE ACCREDITATION STANDARDS THAT
INDICATE A RISK TO THE SAFETY OF PATIENT(S) OR QUALITY
OF HEALTH CARE SERVICES (92)
Name of Agency or Program
That Took the Adverse Action
Specified in This Report: FOOTCAREREGULATIONBODY
Adverse Action
Classification Code(s): ACCREDITATION TERMINATED (3850)
Date Action Was Taken: 11/26/2014

CONFIDENTIAL DOCUMENT - FOR AUTHORIZED USE ONLY

the

DataBank

DCN: 5950000090960758
Process Date: 11/26/2014
Page: 2
of
2
FOOTCAREINC
For authorized use by:
ASHI

P.O. Box 10832
Chantilly, VA 20153-0832
http://www.npdb.hrsa.gov
Date Action Became Effective:
Length of Action:
Total Amount of Monetary Penalty,
Assessment and/or Restitution:
Is Subject Automatically Reinstated After
Adverse Action Period Is Completed?:
Description of Subject's Act(s) or Omission(s) or Other
Reasons for Action(s) Taken and Description of Action(s) Taken
by Reporting Entity:

11/26/2014
PERMANENT
$ 1.00
YES

BAD FOOT CARE PRACTICES.

D. SUBJECT
STATEMENT

If the subject identified in Section B of this report has submitted a statement, it appears in this section.

E. REPORT STATUS

Unless a box below is checked, the subject of this report identified in Section B has not contested this report.
This report has been disputed by the subject identified in Section B.
At the request of the subject identified in Section B, this report is being reviewed by the Secretary of the
U.S. Department of Health and Human Services to determine its accuracy and/or whether it complies with
reporting requirements. No decision has been reached.
At the request of the subject identified in Section B, this report was reviewed by the Secretary of the U.S.
Department of Health and Human Services and a decision was reached. The subject has requested that
the Secretary reconsider the original decision.
At the request of the subject identified in Section B, this report was reviewed by
the Secretary of the U.S. Department of Health and Human Services. The Secretary’s decision
is shown below:
Date of Original Submission:

11/26/2014

Date of Most Recent Change:

11/26/2014

This report is maintained under the provisions of: Section 1921
The information contained in this report is maintained by the National Practitioner Data Bank for restricted use under the
provisions of Section 1921 of the Social Security Act, and 45 CFR Part 60. All information is confidential and may be used only for
the purpose for which it was disclosed. Disclosure or use of confidential information for other purposes is a violation of federal law.
For additional information or clarification, contact the reporting entity identified in Section A.
END OF REPORT

CONFIDENTIAL DOCUMENT - FOR AUTHORIZED USE ONLY