NPIMap

Organization Active NPI

Foot & Ankle Center of Wenatchee, P.S.

  • Podiatrist
  • Wenatchee, WA
National Provider Identifier
1114146263
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
600366213 Issued in WA
Legal business name
FOOT & ANKLE CENTER OF WENATCHEE, P.S.
Practice address
616 N Chelan Ave
Wenatchee, WA 98801-2025
Phone
(509) 662-2970
Fax
(509) 665-9808
NPI assigned
Apr 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Authorized official

Name
Yessica G Beasley
Title
Assistant Manager
Phone
(509) 662-2970

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X 600366213 WA Primary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 600366213 WA
Foot Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0131X 600366213 WA

Addresses

Primary practice location

616 N Chelan Ave
Wenatchee, WA 98801-2025

Mailing address

616 N Chelan Ave
Wenatchee, WA 98801-2025
Phone (509) 662-2970

Other identifiers 3

IdentifierTypeStateIssuer
7185101MedicaidWA
CS9149OtherWAPROF GROUP # FOR RR MEDIC
35677OtherWAPROF GROUP # FOR L&I

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040402000882 WA Part B Supplier - Clinic/Group Practice 2365333879 Receives reassigned benefits from 4 practitioners
Practice locations: Wenatchee, WA
O20100930082857 WA DME Supplier - Physician - Podiatry 2365333879 Practice locations: Wenatchee, WA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

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": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1114146263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "616 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012025",
            "telephone_number": "509-662-2970",
            "fax_number": "509-665-9808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012025",
            "telephone_number": "509-662-2970",
            "fax_number": "509-665-9808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE CENTER OF WENATCHEE, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A",
        "authorized_official_last_name": "BEASLEY",
        "authorized_official_first_name": "YESSICA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ASSISTANT MANAGER",
        "authorized_official_telephone_number": "509-662-2970"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "600366213",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "600366213",
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "WA",
            "license": "600366213",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7185101",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROF GROUP # FOR RR MEDIC",
            "identifier": "CS9149",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROF GROUP # FOR L&I",
            "identifier": "35677",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2023; 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.