Active NPI
Elite Ankle & Foot
- Podiatrist
- Mt Pleasant, UT
National Provider Identifier
1134500044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- Legal business name
- ELITE ANKLE & FOOT
- Practice address
- 1075 S Highway 89
Mt Pleasant, UT 84647-2305 - Phone
- (435) 462-3668
- Fax
- (844) 626-2455
- NPI assigned
- Jun 16, 2015
- 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
- Tyler Jolley
- Title
- Owner
- Phone
- (435) 462-3668
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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | Primary |
Addresses
Primary practice location
1075 S Highway 89
Mt Pleasant, UT 84647-2305
Mailing address
PO Box 398
Mt Pleasant, UT 84647-0398
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150915003012 | UT | Part B Supplier - Clinic/Group Practice | 8325355878 |
Receives reassigned benefits from 1 practitioner Practice locations: Mount Pleasant, UT; Gunnison, UT |
| O20160505000258 | UT | DME Supplier - Physician - Podiatry | 8325355878 | Practice locations: Mt. Pleasant, UT |
National Provider Directory
National Provider DirectoryLocations
1125 Blackhawk Blvd
Ste D
Mt Pleasant, UT 84647
Practitioners & affiliated clinicians
Practitioners 1
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": "1434412800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1713744000000",
"number": "1134500044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 398",
"city": "MT PLEASANT",
"state": "UT",
"postal_code": "846470398"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1075 S HIGHWAY 89",
"city": "MT PLEASANT",
"state": "UT",
"postal_code": "846472305",
"telephone_number": "435-462-3668",
"fax_number": "844-626-2455"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ELITE ANKLE & FOOT",
"organizational_subpart": "NO",
"enumeration_date": "2015-06-16",
"last_updated": "2024-04-22",
"certification_date": "2024-04-15",
"status": "A",
"authorized_official_last_name": "JOLLEY",
"authorized_official_first_name": "TYLER",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "435-462-3668"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mt Pleasant, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; 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.