Organization Active NPI

Rio Grande Foot & Ankle Specialists LLC

  • Foot & Ankle Surgery Podiatrist
  • Santa Fe, NM
National Provider Identifier
1285300673
Registry record updated Jan 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
RIO GRANDE FOOT & ANKLE SPECIALISTS LLC
Practice address
404 Brunn School Rd
Santa Fe, NM 87505-1102
Phone
(505) 395-9575
Fax
(877) 540-1253
NPI assigned
Aug 17, 2021
Organization subpart
Yes
Parent organization
RIO GRANDE FOOT & ANKLE SPECIALISTSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2025

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

Authorized official

Name
Michelle DeithloffNPI 1588073290
Title
DPM
Phone
(801) 643-2921

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

404 Brunn School Rd
Santa Fe, NM 87505-1102

Mailing address

2561 S 1560 W Ste B
Woods Cross, UT 84087-2361
Phone (801) 505-0821

National Provider Directory

National Provider Directory
Part of
Rio Grande Foot Ankle Specialists LLC

Member of 1

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

Locations

1475 Central Ave
Ste 150
Los Alamos, NM 87544
Phone (505) 662-2020

404 Brunn School Rd
Ste A
Santa Fe, NM 87505
Phone (505) 988-7568

2561 S 1560 W
Ste B
Woods Cross, UT 84087

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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": "1629158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738022400000",
    "number": "1285300673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2561 S 1560 W STE B",
            "city": "WOODS CROSS",
            "state": "UT",
            "postal_code": "840872361",
            "telephone_number": "801-505-0821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 BRUNN SCHOOL RD",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875051102",
            "telephone_number": "505-395-9575",
            "fax_number": "877-540-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIO GRANDE FOOT & ANKLE SPECIALISTS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIO GRANDE FOOT & ANKLE SPECIALISTS",
        "enumeration_date": "2021-08-17",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A",
        "authorized_official_last_name": "DEITHLOFF",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "801-643-2921"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2025; 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.