Active NPI
Paul C Pearson, D.P.M.
- Podiatrist
- Amarillo, TX
National Provider Identifier
1194769711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 1389
- Practice address
- 7305-A Wallace Blvd
Amarillo, TX 79106-1815 - Phone
- (806) 356-0151
- Fax
- (806) 457-1656
- NPI assigned
- Jun 15, 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 1389 | TX | Primary |
Addresses
Primary practice location
7305-A Wallace Blvd
Amarillo, TX 79106-1815
Mailing address
7305 Wallace Blvd
Amarillo, TX 79106-1815
Phone (806) 356-0151
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 092747701 | Medicaid | TX |
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 |
|---|---|---|---|
| 1389 | TX | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wyatt Clinic, P.a. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Family Medicine Physician
- Amarillo, TX
- NPI 1639280431
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1219622400000",
"number": "1194769711",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7305 WALLACE BLVD",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791061815",
"telephone_number": "806-356-0151",
"fax_number": "806-457-1656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7305-A WALLACE BLVD",
"city": "AMARILLO",
"state": "TX",
"postal_code": "791061815",
"telephone_number": "806-356-0151",
"fax_number": "806-457-1656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEARSON",
"first_name": "PAUL",
"middle_name": "C",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2008-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "TX",
"license": "1389",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "092747701",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Amarillo, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 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.