Active NPI
Foot Specialists of Tyler, PA
- Durable Medical Equipment & Medical Supplies
- Tyler, TX
National Provider Identifier
1114109170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- L1375
- Legal business name
- FOOT SPECIALISTS OF TYLER, PA
- Practice address
- 649 S Broadway Ave
Suite 2
Tyler, TX 75701-1677 - Phone
- (903) 592-7200
- Fax
- (903) 592-7211
- NPI assigned
- Dec 3, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Charles D Rhodus, DPM
- Title
- Owner
- Phone
- (903) 592-7200
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | L1375 | TX | Primary |
Addresses
Primary practice location
649 S Broadway Ave
Suite 2
Tyler, TX 75701-1677
Mailing address
649 S. Broadway Ave
Suite 2
Tyler, TX 75701
Phone (903) 592-7200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5885310001 | Other | TX | PALMETTO PIN |
National Provider Directory
National Provider Directory- Tax ID family
- Foot Specialists of Tyler PA
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Podiatrist
- Tyler, TX
- NPI 1568504371
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Podiatrist
- Tyler, TX
- NPI 1962495341
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196640000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1196640000000",
"number": "1114109170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "649 S. BROADWAY AVE",
"address_2": "SUITE 2",
"city": "TYLER",
"state": "TX",
"postal_code": "75701",
"telephone_number": "903-592-7200",
"fax_number": "903-592-7211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "649 S BROADWAY AVE",
"address_2": "SUITE 2",
"city": "TYLER",
"state": "TX",
"postal_code": "757011677",
"telephone_number": "903-592-7200",
"fax_number": "903-592-7211"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOOT SPECIALISTS OF TYLER, PA",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-03",
"last_updated": "2007-12-03",
"status": "A",
"authorized_official_last_name": "RHODUS",
"authorized_official_first_name": "CHARLES",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "903-592-7200",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "TX",
"license": "L1375",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO PIN",
"identifier": "5885310001",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.