Henderson Foot and Ankle Center LLC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

1008 Issued in NV

Legal business name

HENDERSON FOOT AND ANKLE CENTER LLC

Practice address

1485 W Warm Springs Rd Ste 102
Henderson, NV 89014-7632

Phone

(702) 435-7987

Fax

(702) 435-7616

NPI assigned

Sep 8, 2010

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth E Fatkin, DPMNPI 1922238195

Title

Owner

Phone

(702) 435-7987

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Ervine Fatkin, DPM

  • Primary Podiatric Medicine Podiatrist
  • Henderson, NV
  • NPI 1922238195
  Authorized official Same address or phone

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1144537523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 W WARM SPRINGS RD",
            "address_2": "SUITE 102",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890147632",
            "telephone_number": "702-435-7987",
            "fax_number": "702-435-7616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 W WARM SPRINGS RD STE 102",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890147632",
            "telephone_number": "702-435-7987",
            "fax_number": "702-435-7616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HENDERSON FOOT AND ANKLE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-08",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FATKIN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-435-7987",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NV",
            "license": "1008",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NV",
            "license": "1008",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henderson Coronado NV Opco LLC
• Henderson Counseling Services, LLC
• Henderson Delmar NV Opco LLC
• Henderson Dermatology and Skin Cancer Inc
• Henderson Family Eyecare
• Henderson Hospital
• Henderson Hospital (ER at Cadence)
• Henderson Hospital (ER at Green Valley Ranch)
• Henderson Hospital
• Henderson Knee and Joint Clinic LLC

• Podiatric Clinic/Center in Henderson, NV
• Providers in Henderson, NV by specialty
• Podiatric Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.