Foot & Ankle Clinic of Spokane

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO00000715 Issued in WA

Legal business name

FOOT & ANKLE CLINIC OF SPOKANE

Practice address

9405 E Sprague Ave
Spokane Valley, WA 99206-3694

Phone

(509) 928-8181

Fax

(509) 926-1247

NPI assigned

Aug 22, 2005

Last updated

Aug 22, 2020By 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

Dr. Jacqueline M Babol, DPMNPI 1528050994

Title

Owner Doctor

Phone

(509) 928-8181

Specialties & licenses 1

Addresses

Other identifiers 4

Tax ID family

Mountain Health Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Foot and Ankle Clinic of Spokane Inc

  • Durable Medical Equipment & Medical Supplies
  • Spokane Valley, WA
  • NPI 1124109590
  NPD tax ID
• Foot and Ankle Clinic of Spokane Inc

  dba Surgery Center of Spokane

  • Foot & Ankle Surgery Podiatrist
  • Spokane Valley, WA
  • NPI 1497839823
  NPD tax ID
• Foot and Ankle Clinic of Spokane Inc

  dba Surgery Center of Spokane

  • Ambulatory Surgical Clinic/Center
  • Spokane Valley, WA
  • NPI 1548252968
  NPD tax ID

Locations

Practitioners 1

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.

• Jacqueline Mendoza Babol, DPM

  • Podiatrist
  • Spokane, WA
  • NPI 1528050994
  NPD (past) Authorized official

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285626622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9405 E SPRAGUE AVE",
            "address_2": "POB 13070",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992063694",
            "telephone_number": "509-928-8181",
            "fax_number": "509-926-1247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9405 E SPRAGUE AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992063694",
            "telephone_number": "509-928-8181",
            "fax_number": "509-926-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE CLINIC OF SPOKANE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BABOL",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "509-928-8181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO00000715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC PIN",
            "identifier": "4797370001",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1116623",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS DMERC",
            "identifier": "9055492",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE",
            "identifier": "693OBO",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michele Lynn Foglia, DMD
• Sarah L Foley
• Kristina Marie Follger, FNP
• Edwin Fonseca, MSW
• Mecque Fonseca
• Foot and Ankle Clinic of Spokane Inc
• Foot and Ankle Clinic of Spokane Inc (Surgery Center of Spokane)
• Foot and Ankle Clinic of Spokane Inc (Surgery Center of Spokane)
• Cindy Lee Forbes, LMT
• Cynthia Marie Ford, LMHCA

• Foot & Ankle Surgery Podiatrist in Spokane Valley, WA
• Providers in Spokane Valley, WA by specialty
• Foot & Ankle Surgery Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.