Treasure Valley Foot and Ankle

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

TREASURE VALLEY FOOT AND ANKLE

Practice address

3120 W Belltower Dr Ste 100
Meridian, ID 83646-7744

Phone

(208) 516-3617

Fax

(208) 314-2029

NPI assigned

Aug 20, 2019

Last updated

Dec 16, 2019By 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

Clark A JohnsonNPI 1518225929

Title

President

Phone

(208) 546-9548

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

Locations

Practitioners 2

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.

• Clark A Johnson, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Meridian, ID
  • NPI 1518225929
  Medicare reassignment NPD Authorized official
• Jeffrey Garcia, OPTOMETRIST

  • Optometrist
  • Lemoore, CA
  • NPI 1699782516
  NPD

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1083261697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840110268",
            "telephone_number": "208-516-3617",
            "fax_number": "208-314-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 W BELLTOWER DR STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467744",
            "telephone_number": "208-516-3617",
            "fax_number": "208-314-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREASURE VALLEY FOOT AND ANKLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-20",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CLARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-546-9548"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Treasure Valley Connections Counseling PLLC
• Treasure Valley Dermatology & Skin Cancer Center, PLLC
• Treasure Valley Eye Center P a
• Treasure Valley Family Dentistry PC
• Treasure Valley Family Medicine, PLLC
• Treasure Valley Healthcare PLLC
• Treasure Valley Hearing and Balance Clinic, Inc
• Treasure Valley Home Care LLC (Home Instead Senior Care)
• Treasure Valley Home Care, LLC (Home Instead Senior Care)
• Treasure Valley Hospice LLC

• Foot & Ankle Surgery Podiatrist in Meridian, ID
• Providers in Meridian, ID by specialty
• Foot & Ankle Surgery Podiatrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.