Grand Forks Foot and Ankle Clinic, PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

48 Issued in ND

Legal business name

GRAND FORKS FOOT AND ANKLE CLINIC, PLLC

Practice address

1451 44TH Ave S Ste 128D
Grand Forks, ND 58201-3434

Phone

(701) 738-2770

NPI assigned

Apr 16, 2007

Last updated

Mar 14, 2008By 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. John Carlyle Miller, DPMNPI 1407810575

Title

President

Phone

(701) 738-2770

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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.

• John Carlyle Miller, DPM

  • Foot & Ankle Surgery Podiatrist
  • Durango, CO
  • NPI 1407810575
  NPD (past) Authorized official

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1164647822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1451 44TH AVE S STE 128D",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013434",
            "telephone_number": "701-738-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 44TH AVE S STE 128D",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582013434",
            "telephone_number": "701-738-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND FORKS FOOT AND ANKLE CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CARLYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-738-2770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ND",
            "license": "48",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLURE CROSS BLUE SHIELD",
            "identifier": "06740-001",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "13707",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grand Forks Anesthesia Services PC
• Grand Forks Chiropractic
• Grand Forks Clinic Pharmacy
• Grand Forks Counseling and Therapy PLLC
• Grand Forks County Social Services
• Grand Forks Growth and Support Center
• Grand Forks Head Start
• Grand Forks Public School District
• Grand Forks Public Schools District 1
• Grand Forks Public Schools District 1

• Foot & Ankle Surgery Podiatrist in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Foot & Ankle Surgery Podiatrist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; 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.