Oregon Family Foot and Ankle, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

36003491 Issued in OH

Legal business name

OREGON FAMILY FOOT AND ANKLE, LLC

Practice address

1050 Isaac Streets Dr Ste 122
Oregon, OH 43616-3243

Phone

(419) 693-4171

Fax

(419) 693-6863

NPI assigned

Dec 12, 2008

Last updated

Jun 7, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Michael D. Cragel, D.P.M.

Title

General Partner

Phone

(419) 693-4171

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1229040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339027200000",
    "number": "1235374687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 ISAAC STREETS DR. #122",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "43616",
            "telephone_number": "419-693-4171",
            "fax_number": "419-693-6863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 ISAAC STREETS DR STE 122",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163243",
            "telephone_number": "419-693-4171",
            "fax_number": "419-693-6863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OREGON FAMILY FOOT AND ANKLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-12",
        "last_updated": "2012-06-07",
        "status": "A",
        "authorized_official_last_name": "CRAGEL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "419-693-4171",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36003491",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "2026",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0497752",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2861390",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Oregon, OH
• Providers in Oregon, OH by specialty
• Foot & Ankle Surgery Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.