Organization Active NPI

Total Foot and Ankle LLC

  • Podiatrist
  • Plano, TX
National Provider Identifier
1003467770
Registry record updated Nov 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
TOTAL FOOT AND ANKLE LLC
Practice address
6300 W Parker Rd Ste 425
Plano, TX 75093-8104
Phone
(972) 942-8080
Fax
(972) 759-9083
NPI assigned
Sep 24, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2022

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

Authorized official

Name
Tammie Marie Jackson
Title
Practice Manager
Phone
(214) 676-9392

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

6300 W Parker Rd Ste 425
Plano, TX 75093-8104

Mailing address

6300 W Parker Rd Ste 425
Plano, TX 75093-8104
Phone (972) 942-8080

Other identifiers 1

IdentifierTypeStateIssuer
4122517MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191127000174 TX Part B Supplier - Clinic/Group Practice 9830522143 Receives reassigned benefits from 1 practitioner
Practice locations: Plano, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668470400000",
    "number": "1003467770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 W PARKER RD STE 425",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938104",
            "telephone_number": "972-942-8080",
            "fax_number": "972-759-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 W PARKER RD STE 425",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938104",
            "telephone_number": "972-942-8080",
            "fax_number": "972-759-9083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL FOOT AND ANKLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-24",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TAMMIE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "214-676-9392"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4122517",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.