Organization Active NPI

Ankle & Foot Clinic, PS

  • Podiatrist
  • Vancouver, WA
National Provider Identifier
1285823005
Registry record updated Jan 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO00000402 Issued in WA
Legal business name
ANKLE & FOOT CLINIC, PS
Practice address
416 NE 87TH Ave
Ste #2
Vancouver, WA 98664-1930
Phone
(360) 256-1777
Fax
(360) 696-4287
NPI assigned
Oct 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2008

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

Authorized official

Name
Denice L Nolan
Title
Office Manager
Phone
(360) 256-1777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X PO00000402 WA Primary

Addresses

Primary practice location

416 NE 87TH Ave
Ste #2
Vancouver, WA 98664-1930

Mailing address

416 NE 87TH Ave
Ste #2
Vancouver, WA 98664-1930
Phone (360) 256-1777

Other identifiers 1

IdentifierTypeStateIssuer
7113566MedicaidWA

National Provider Directory

National Provider Directory

Locations

102 W Fourth Plain Blvd
#B
Vancouver, WA 98660
Phone (360) 696-4400

102 W Fourth Plain Blvd
Ste A
Vancouver, WA 98660
Phone (360) 696-4431

Practitioners & affiliated clinicians

Practitioners 4

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": "1192579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200528000000",
    "number": "1285823005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 NE 87TH AVE",
            "address_2": "STE #2",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641930",
            "telephone_number": "360-256-1777",
            "fax_number": "360-696-4287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 NE 87TH AVE",
            "address_2": "STE #2",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986641930",
            "telephone_number": "360-256-1777",
            "fax_number": "360-696-4287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANKLE & FOOT CLINIC, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-17",
        "last_updated": "2008-01-17",
        "status": "A",
        "authorized_official_last_name": "NOLAN",
        "authorized_official_first_name": "DENICE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "360-256-1777"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO00000402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7113566",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; 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.