Frontier Foot and Ankle Specialists LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

FRONTIER FOOT AND ANKLE SPECIALISTS LLC

Practice address

780 2ND St SE # 10
Bandon, OR 97411-8354

Phone

(971) 247-1080

Fax

(971) 223-3243

NPI assigned

Jun 23, 2020

Last updated

Feb 20, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Babak BaharlooNPI 1740662147

Title

Owner

Phone

(541) 329-2555

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR2 enrollments

Enrollment records 2

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Babak Baharloo

  • Podiatrist
  • Houston, TX
  • NPI 1740662147

  OR

  Medicare reassignment Care Compare group NPD Authorized official
• Davina Lynn Bledsoe, FNP-BC

  • Nurse Practitioner
  • Coos Bay, OR
  • NPI 1295245108
  Medicare reassignment Care Compare group NPD
• Ahmad Rashad Namous, DPM

  • Sports Medicine Podiatrist
  • Seattle, WA
  • NPI 1578180584

  OR

  Medicare reassignment Care Compare group NPD
• Ivy Christine Wagner, DBH, LCSW

  • Clinical Social Worker
  • Bandon, OR
  • NPI 1346754702
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1003432204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 2ND ST SE # 10",
            "city": "BANDON",
            "state": "OR",
            "postal_code": "974118354",
            "telephone_number": "971-247-1080",
            "fax_number": "971-223-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 2ND ST SE # 10",
            "city": "BANDON",
            "state": "OR",
            "postal_code": "974118354",
            "telephone_number": "971-247-1080",
            "fax_number": "971-223-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRONTIER FOOT AND ANKLE SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-23",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "BAHARLOO",
        "authorized_official_first_name": "BABAK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-329-2555"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "baharloobabak@gmail.com",
            "affiliation": "N",
            "address_1": "780 2nd St SE # 10",
            "city": "Bandon",
            "state": "OR",
            "country_code": "US",
            "postal_code": "974118354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Julie Griffin, CADC II

• Foot & Ankle Surgery Podiatrist in Bandon, OR
• Providers in Bandon, OR by specialty
• Foot & Ankle Surgery Podiatrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.