Active NPI
Jeffrey Clarke Page, DPM
- Foot Surgery Podiatrist
- Glendale, AZ
National Provider Identifier
1164524138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- License
- 0623
- Practice address
- 19389 N 59TH Ave
Glendale, AZ 85308-6500 - Phone
- (623) 537-6000
- Fax
- (623) 537-6014
- NPI assigned
- Sep 1, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | 0623 | AZ | Primary |
Addresses
Primary practice location
19389 N 59TH Ave
Glendale, AZ 85308-6500
Mailing address
19555 N 59TH Ave
Glendale, AZ 85308-6813
Phone (623) 537-6000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 364313 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0623 | AZ | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1261440000000",
"number": "1164524138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19555 N 59TH AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086813",
"telephone_number": "623-537-6000",
"fax_number": "623-537-6014"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19389 N 59TH AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086500",
"telephone_number": "623-537-6000",
"fax_number": "623-537-6014"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGE",
"first_name": "JEFFREY",
"middle_name": "CLARKE",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-01",
"last_updated": "2009-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "AZ",
"license": "0623",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "364313",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.