Family Foot & Ankle

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

7054576-0501 Issued in UT

Legal business name

FAMILY FOOT & ANKLE

Practice address

491 N Main St
Tooele, UT 84074-1654

Phone

(515) 205-5635

NPI assigned

Jun 18, 2017

Organization subpart

Yes

Parent organization

FAMILY FOOT & ANKLEAs reported in NPPES

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

Authorized official

Name

Jeffrey Lynn Carlson, DPM

Title

Podiatrist

Phone

(515) 205-5635

Specialties & licenses 1

Addresses

Part of

Family Foot Ankle

Locations

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497744000000",
    "number": "1083144406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1332 E 630 S",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840744436",
            "telephone_number": "515-205-5635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "491 N MAIN ST",
            "city": "TOOELE",
            "state": "UT",
            "postal_code": "840741654",
            "telephone_number": "515-205-5635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FOOT & ANKLE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY FOOT & ANKLE",
        "enumeration_date": "2017-06-18",
        "last_updated": "2017-06-18",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "515-205-5635",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "UT",
            "license": "7054576-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatric Clinic/Center in Tooele, UT
• Providers in Tooele, UT by specialty
• Podiatric Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.