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Ellsworth Foot and Ankle

Organization Active NPI Podiatrist · Delta, UT

NPI 1003567926 · NPPES record last updated Jan 12, 2022

Key facts

NPI
1003567926
Entity type
Organization (NPI type 2)
Primary specialty
Podiatrist 213E00000X
Legal business name
ELLSWORTH FOOT AND ANKLE
Practice address
95 White Sage Ave
Delta, UT 84624-5555
Phone
(801) 253-6886
NPI assigned
Jan 12, 2022
Organization subpart
No

Authorized official

Name
Allison Peck
Title
Credentialing Specialist
Phone
(801) 253-6886

Corporate family (same tax ID) 9

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Ellsworth Foot and Ankle (10 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist
Group: 193400000X SINGLE SPECIALTY GROUP		 213E00000X Yes

Addresses

Primary practice location

95 White Sage Ave
Delta, UT 84624-5555

Mailing address

9980 S 300 W Ste 310
Sandy, UT 84070-3654
Phone (801) 253-6886

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 12, 2022.

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1003567926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9980 S 300 W STE 310",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840703654",
            "telephone_number": "801-253-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 WHITE SAGE AVE",
            "city": "DELTA",
            "state": "UT",
            "postal_code": "846245555",
            "telephone_number": "801-253-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLSWORTH FOOT AND ANKLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "801-253-6886"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delta, UT

All providers in Delta, UT · Podiatrist in Utah

Sources for this page

Verify at the official NPI Registry.