Organization Active NPI

Foot & Ankle Surgeons of Oklahoma PLLC

  • Foot & Ankle Surgery Podiatrist
  • Moore, OK
National Provider Identifier
1174106827
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FOOT & ANKLE SURGEONS OF OKLAHOMA PLLC
Practice address
1401 SW 34TH St Ste 320
Moore, OK 73160-3059
Phone
(405) 418-4500
Fax
(405) 418-4501
NPI assigned
Apr 30, 2021
Last updated
Apr 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Authorized official

Name
Christopher James Green, DPMNPI 1831357417
Title
Owner
Phone
(405) 418-4500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

1401 SW 34TH St Ste 320
Moore, OK 73160-3059

Mailing address

PO Box 268996
Oklahoma City, OK 73126-8996
Phone (405) 418-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210617001176 OK DME Supplier - Physician - Podiatry 4587810817 Practice locations: Moore, OK

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory
Tax ID family
Foot Ankle Surgeons of Ok7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1174106827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268996",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731268996",
            "telephone_number": "405-418-4500",
            "fax_number": "405-418-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SW 34TH ST STE 320",
            "city": "MOORE",
            "state": "OK",
            "postal_code": "731603059",
            "telephone_number": "405-418-4500",
            "fax_number": "405-418-4501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE SURGEONS OF OKLAHOMA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-418-4500",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.