NPIMap

Organization Active NPI

Pryme Foot & Ankle Center PLLC

  • Podiatric Clinic/Center
  • Mansfield, TX
National Provider Identifier
1154844348
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
PRYME FOOT & ANKLE CENTER PLLC
Practice address
1759 Broad Park Cir S #205
Mansfield, TX 76063-7834
Phone
(682) 223-2400
Fax
(682) 334-7061
NPI assigned
Jul 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Authorized official

Name
Randy Hamilton, DMD
Title
Owner
Phone
(682) 223-2400

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X
Podiatric Clinic/Center 261QP1100X Primary

Addresses

Primary practice location

1759 Broad Park Cir S #205
Mansfield, TX 76063-7834

Mailing address

1759 Broad Park Cir S #205
Mansfield, TX 76063-7834
Phone (682) 223-2400

Other identifiers 1

IdentifierTypeStateIssuer
811363748OtherTAX ID

National Provider Directory

National Provider Directory

Locations

305 Regency Pkwy
Ste 801
Mansfield, TX 76063
Phone (682) 223-2400

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": "1500508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517356800000",
    "number": "1154844348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1759 BROAD PARK CIR S #205",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637834",
            "telephone_number": "682-223-2400",
            "fax_number": "682-334-7061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1759 BROAD PARK CIR S #205",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637834",
            "telephone_number": "682-223-2400",
            "fax_number": "682-334-7061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRYME FOOT & ANKLE CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-20",
        "last_updated": "2018-01-31",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "682-223-2400",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "811363748",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.