101 Foot and Ankle Inc.

Primary specialty

PodiatristTaxonomy code 213E00000X

Legal business name

101 FOOT AND ANKLE INC.

Practice address

450 Rosewood Ave Ste 104
Camarillo, CA 93010-5914

Phone

(805) 200-6994

NPI assigned

Jan 11, 2023

Last updated

Mar 28, 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

Dr. Alice Jen Kim, DPMNPI 1730616145

Title

Doctor

Phone

(805) 200-6994

Specialties & licenses 1

Addresses

Other names 1

• Alice J. Kim DPM Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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.

• Alice Jen Kim, DPM

  • Podiatrist
  • Camarillo, CA
  • NPI 1730616145
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1673395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743120000000",
    "number": "1043924335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5016 VIA CUPERTINO",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930125240",
            "telephone_number": "805-200-6994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 ROSEWOOD AVE STE 104",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930105914",
            "telephone_number": "805-200-6994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "101 FOOT AND ANKLE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-11",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "ALICE",
        "authorized_official_middle_name": "JEN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "805-200-6994",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alice J. Kim DPM",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Podiatrist in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.