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

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, DPM

Title

Owner

Phone

(702) 435-7987

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

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
• Henderson Hospital
• Henderson Hospital
• Henderson Knee and Joint Clinic LLC

• All providers in Henderson, NV
• 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.