Organization Active NPI

Castle Rock Foot & Ankle Care PC

  • Foot & Ankle Surgery Podiatrist
  • Castle Rock, CO
National Provider Identifier
1104123249
Registry record updated Nov 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
686 Issued in CO
Legal business name
CASTLE ROCK FOOT & ANKLE CARE PC
Practice address
2352 Meadows Blvd Ste 270
Castle Rock, CO 80109
Phone
(303) 814-1082
Fax
(303) 814-0020
NPI assigned
Feb 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2022

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

Authorized official

Name
Dr. Jessica Herzog, DPMNPI 1609044585
Title
Physician
Phone
(303) 814-1082

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 686 CO Primary

Addresses

Primary practice location

2352 Meadows Blvd Ste 270
Castle Rock, CO 80109

Mailing address

PO Box 639
Castle Rock, CO 80104-0639
Phone (303) 814-1082

Other practice location 1

8671 S Quebec St Ste 230
Highlands Ranch, CO 80130-5861
Phone (303) 814-1082

Other identifiers 1

IdentifierTypeStateIssuer
9000150592MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20110502000400 CO DME Supplier - Physician - Podiatry 4587849872 Practice locations: Castle Rock, CO
O20110614000638 CO Part B Supplier - Clinic/Group Practice 4587849872 Receives reassigned benefits from 6 practitioners
Practice locations: Castle Rock, CO

National Provider Directory

National Provider Directory

Locations

2352 Meadows Blvd
Ste 270
Castle Rock, CO 80109
Phone (303) 814-1082

Practitioners & affiliated clinicians

Practitioners 7

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": "1298592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1104123249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801040639",
            "telephone_number": "303-814-1082",
            "fax_number": "303-814-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2352 MEADOWS BLVD STE 270",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "80109",
            "telephone_number": "303-814-1082",
            "fax_number": "303-814-0020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8671 S Quebec St Ste 230",
            "address_purpose": "LOCATION",
            "city": "Highlands Ranch",
            "state": "CO",
            "postal_code": "801305861",
            "country_code": "US",
            "telephone_number": "303-814-1082",
            "fax_number": "303-814-0020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CASTLE ROCK FOOT & ANKLE CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-25",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "303-814-1082",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000150592",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Castle Rock, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.