NPIMap

Organization Active NPI

Ankle & Foot Specialists of Puget Sound, PS

  • Podiatrist
  • Enumclaw, WA
National Provider Identifier
1164720462
Registry record updated Jul 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
ANKLE & FOOT SPECIALISTS OF PUGET SOUND, PS
Practice address
2820 Griffin Ave
Suite 101
Enumclaw, WA 98022-2373
Phone
(360) 825-2181
Fax
(360) 825-8354
NPI assigned
Mar 10, 2011
Organization subpart
Yes
Parent organization
ANKLE & FOOT SPECIALISTS OF PUGET SOUND, PSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 24, 2012

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

Authorized official

Name
Charles R Chu, DPM
Title
Owner
Phone
(425) 449-2471

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X Primary
Primary Podiatric Medicine PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213EP1101X
Foot Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0131X

Addresses

Primary practice location

2820 Griffin Ave
Suite 101
Enumclaw, WA 98022-2373

Mailing address

2728 E Main Ave
Suite a
Puyallup, WA 98372-3198
Phone (253) 841-2006

Other names 1

  • Enumclaw Foot & Ankle Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040218000487 WA Part B Supplier - Clinic/Group Practice 7214822253 Receives reassigned benefits from 7 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Puyallup, WA; Redmond, WA; Issaquah, WA; Enumclaw, WA; Covington, WA; Bonney Lake, WA; Bellevue, WA
O20120621000625 WA DME Supplier - Physician - Podiatry 7214822253 Practice locations: Enumclaw, WA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Factoria Foot and Ankle12 organizations share this tax ID, including this one
Part of
Factoria Foot and Ankle

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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": "1299715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1164720462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 E MAIN AVE",
            "address_2": "SUITE A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723198",
            "telephone_number": "253-841-2006",
            "fax_number": "253-840-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 GRIFFIN AVE",
            "address_2": "SUITE 101",
            "city": "ENUMCLAW",
            "state": "WA",
            "postal_code": "980222373",
            "telephone_number": "360-825-2181",
            "fax_number": "360-825-8354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANKLE & FOOT SPECIALISTS OF PUGET SOUND, PS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANKLE & FOOT SPECIALISTS OF PUGET SOUND, PS",
        "enumeration_date": "2011-03-10",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "CHU",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-449-2471",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enumclaw Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enumclaw, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; 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.