NPIMap

Organization Active NPI

Neil a Van Dyck, DPM, Podiatry Corporation

  • Podiatrist
  • Roseville, CA
National Provider Identifier
1235438136
Registry record updated Sep 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E2481 Issued in CA
Legal business name
NEIL A VAN DYCK, DPM, PODIATRY CORPORATION
Practice address
1650 Lead Hill Blvd
# 100
Roseville, CA 95661-3061
Phone
(916) 786-3434
Fax
(916) 786-6770
NPI assigned
Mar 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2013

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

Authorized official

Name
Mr. Rusty Sparkman
Title
Billing Manager
Phone
(916) 640-0515

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X E2481 CA Primary

Addresses

Primary practice location

1650 Lead Hill Blvd
# 100
Roseville, CA 95661-3061

Mailing address

1650 Lead Hill Blvd
# 100
Roseville, CA 95661-3061
Phone (916) 786-3434

National Provider Directory

National Provider Directory

Locations

1650 Lead Hill Blvd
Ste 100
Roseville, CA 95661
Phone (916) 669-5805

311 Oak Ridge Dr
Ste 2
Roseville, CA 95661
Phone (916) 786-3434

1650 Lead Hill Blvd
Ste 10
Roseville, CA 95661
Phone (916) 786-3434

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1300406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378252800000",
    "number": "1235438136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LEAD HILL BLVD",
            "address_2": "# 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613061",
            "telephone_number": "916-786-3434",
            "fax_number": "916-786-6770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 LEAD HILL BLVD",
            "address_2": "# 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613061",
            "telephone_number": "916-786-3434",
            "fax_number": "916-786-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEIL A VAN DYCK, DPM, PODIATRY CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-18",
        "last_updated": "2013-09-04",
        "status": "A",
        "authorized_official_last_name": "SPARKMAN",
        "authorized_official_first_name": "RUSTY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "916-640-0515",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E2481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2013; 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.