Bozeman Podiatric Clinic Inc

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

79 Issued in MT

Legal business name

BOZEMAN PODIATRIC CLINIC INC

Practice address

1125 W Kagy Blvd Ste 101
Bozeman, MT 59715-5879

Phone

(406) 586-5318

Fax

(406) 586-1635

NPI assigned

Dec 21, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Baden Wright, DPMNPI 1154704377

Title

Owner

Phone

(406) 586-5318

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MT2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Wright, DPM

  • Foot & Ankle Surgery Podiatrist
  • Bozeman, MT
  • NPI 1154704377
  Medicare reassignment Care Compare group NPD Authorized official
• Jan Dean Clark, DMD

  • Podiatrist
  • Bozeman, MT
  • NPI 1497803803
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1144404401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 W KAGY BLVD STE 101",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597155879",
            "telephone_number": "406-586-5318",
            "fax_number": "406-586-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 W KAGY BLVD STE 101",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597155879",
            "telephone_number": "406-586-5318",
            "fax_number": "406-586-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOZEMAN PODIATRIC CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-21",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "BADEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-586-5318",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MT",
            "license": "79",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "M000009239",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Foot & Ankle Surgery Podiatrist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.