NPIMap

Organization Active NPI

Utah Podiatry Group PC

Doing business as Advanced Foot And Ankle Center

  • Foot & Ankle Surgery Podiatrist
  • South Ogden, UT
National Provider Identifier
1225796790
Registry record updated Apr 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
UTAH PODIATRY GROUP PC
Doing business as
Advanced Foot And Ankle Center
Practice address
962 Chambers St
South Ogden, UT 84403-5087
Phone
(801) 373-2499
Fax
(801) 373-5200
NPI assigned
Dec 2, 2021
Last updated
Apr 19, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
UTAH PODIATRY GROUP PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 19, 2025

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

Authorized official

Name
Scott A Clark, DPMNPI 1700865748
Title
DPM
Phone
(801) 505-5277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary
Durable Medical Equipment & Medical Supplies 332B00000X NU

Addresses

Primary practice location

962 Chambers St
South Ogden, UT 84403-5087

Mailing address

PO Box 30015 Dept 380
Salt Lake City, UT 84130
Phone (801) 505-5277

Other names 1

  • Advanced Foot And Ankle Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080530000369 UT Part B Supplier - Clinic/Group Practice 2163592379 Receives reassigned benefits from 15 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Park City, UT; West Jordan, UT; South Ogden, UT; Sandy, UT; Salt Lake City, UT; Millcreek, UT; Highland, UT; Heber City, UT…
O20220329001754 UT DME Supplier - Physician - Podiatry 2163592379 Practice locations: South Ogden, UT

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory
Tax ID family
Utah Podiatry Group PC13 organizations share this tax ID, including this one
Part of
Utah Podiatry Group PC

Other organizations with this tax ID 12

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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": "1638403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745020800000",
    "number": "1225796790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30015 DEPT 380",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84130",
            "telephone_number": "801-505-5277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "962 CHAMBERS ST",
            "city": "SOUTH OGDEN",
            "state": "UT",
            "postal_code": "844035087",
            "telephone_number": "801-373-2499",
            "fax_number": "801-373-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH PODIATRY GROUP PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UTAH PODIATRY GROUP PC",
        "enumeration_date": "2021-12-02",
        "last_updated": "2025-04-19",
        "certification_date": "2025-04-19",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "801-505-5277",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Foot And Ankle Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Foot And Ankle Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2025; 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.