Fall Creek Foot & Ankle PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

2147 Issued in TX

Legal business name

FALL CREEK FOOT & ANKLE PLLC

Practice address

9701 N Sam Houston Pkwy E
Suite 150
Humble, TX 77396-4693

Phone

(281) 973-5237

Fax

(832) 412-2016

NPI assigned

Jul 20, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Travis Scott Bodeker, DPMNPI 1457608051

Title

Owner

Phone

(281) 973-5237

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IHAGAD

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Travis Bodeker, DPM

  • Foot & Ankle Surgery Podiatrist
  • Humble, TX
  • NPI 1457608051
  Medicare reassignment NPD Authorized official
• Brady Hogan, DPM

  • Foot & Ankle Surgery Podiatrist
  • Houston, TX
  • NPI 1730753963
  Medicare reassignment NPD
• Chance Rion Smith, DPM

  • Foot & Ankle Surgery Podiatrist
  • Houston, TX
  • NPI 1932783180
  Medicare reassignment NPD

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484265600000",
    "number": "1194178608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 N SAM HOUSTON PKWY E",
            "address_2": "SUITE 150",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773964693",
            "telephone_number": "281-973-5237",
            "fax_number": "832-412-2016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9701 N SAM HOUSTON PKWY E",
            "address_2": "SUITE 150",
            "city": "HUMBLE",
            "state": "TX",
            "postal_code": "773964693",
            "telephone_number": "281-973-5237",
            "fax_number": "832-412-2016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FALL CREEK FOOT & ANKLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-20",
        "last_updated": "2017-01-13",
        "status": "A",
        "authorized_official_last_name": "BODEKER",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "281-973-5237",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "2147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marie Ruth Fainter
• Fair Care Center Incorporated
• Faith Hope and Mercy Living Center
• Soheil Fakhriravari, DDS
• Fall Creek Family Dental PLLC
• Fall River Surgical, PLLC
• Family First Doctors Urgent Care LLC
• Family Practice Doctors
• Family Practice Doctors Imaging Center
• Family Ties Living Center

• Foot & Ankle Surgery Podiatrist in Humble, TX
• Providers in Humble, TX by specialty
• Foot & Ankle Surgery Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2017; 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.