Organization Active NPI

On the Move Podiatry LLC

  • Foot & Ankle Surgery Podiatrist
  • Phoenix, AZ
National Provider Identifier
1285218750
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
ON THE MOVE PODIATRY LLC
Practice address
19636 N 27TH Ave Ste 207
Phoenix, AZ 85027-4015
Phone
(602) 993-2700
NPI assigned
May 10, 2021
Last updated
Feb 16, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Authorized official

Name
Shelly Ferrulli
Title
Office Manager
Phone
(602) 993-2700

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU
Podiatric Clinic/Center 261QP1100X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

19636 N 27TH Ave Ste 207
Phoenix, AZ 85027-4015

Mailing address

19636 N 27TH Ave Ste 301
Phoenix, AZ 85027-4016
Phone (602) 993-2700

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL onthemovepodiatry@gmail.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20220321000994 AZ Part B Supplier - Clinic/Group Practice 2163817677 Receives reassigned benefits from 3 practitioners
Practice locations: Phoenix, AZ
O20250326002830 AZ DME Supplier - Physician - PodiatryDME Supplier - Multi-Specialty - Physician 2163817677 Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory

Locations

19636 N 27th Ave
Ste 301
Phoenix, AZ 85027
Phone (602) 200-9339

Practitioners & affiliated clinicians

Practitioners 3

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": "1620604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644969600000",
    "number": "1285218750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19636 N 27TH AVE STE 301",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274016",
            "telephone_number": "602-993-2700",
            "fax_number": "602-993-2705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19636 N 27TH AVE STE 207",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274015",
            "telephone_number": "602-993-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ON THE MOVE PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-10",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-16",
        "status": "A",
        "authorized_official_last_name": "FERRULLI",
        "authorized_official_first_name": "SHELLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "602-993-2700"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "onthemovepodiatry@gmail.com",
            "affiliation": "N",
            "address_1": "19636 N 27th Ave Ste 301",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850274016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; 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.