Tri-City Foot & Ankle Center, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO60436994 Issued in WA

Legal business name

TRI-CITY FOOT & ANKLE CENTER, LLC

Practice address

9613 Sandifur Pkwy Ste B
Pasco, WA 99301-8028

Phone

(509) 591-9454

Fax

(509) 578-1118

NPI assigned

Mar 17, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Brent James Thielges, DPMNPI 1043507973

Title

Owner/Provider

Phone

(509) 591-9454

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JGDBBD
• FHIR API: https://api.platform.athenahealth.com/9645/brand/1/csg/1/fhir/r4

Practitioners 2

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

• Brent James Thielges, DPM

  • Foot & Ankle Surgery Podiatrist
  • Pasco, WA
  • NPI 1043507973
  Medicare reassignment Care Compare group NPD Authorized official
• Joshua Benjamin Grimm, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Pasco, WA
  • NPI 1164719092
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1395014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1154747947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9613 SANDIFUR PKWY STE B",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993018028",
            "telephone_number": "509-591-9454",
            "fax_number": "509-578-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9613 SANDIFUR PKWY STE B",
            "city": "PASCO",
            "state": "WA",
            "postal_code": "993018028",
            "telephone_number": "509-591-9454",
            "fax_number": "509-578-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITY FOOT & ANKLE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-17",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "THIELGES",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "509-591-9454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO60436994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2036331",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tri-Cities Community Health
• Tri-Cities Community Health
• Tri-Cities Laboratory LLC
• Tri-Cities Laboratory LLC
• Tri-City Cardiovascular Institute Inc
• Madhuri Tripurana, MS RD CD
• Kerry L Trout, CDP
• Eliane Tshikudi Kahambwe, BS
• Jacqueline G Tuazon, DDS
• Sonia Turner, CDPT

• Foot & Ankle Surgery Podiatrist in Pasco, WA
• Providers in Pasco, WA by specialty
• Foot & Ankle Surgery Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.