NPIMap

Organization Active NPI

Foot & Wound Care of Indio

  • Foot Surgery Podiatrist
  • Indio, CA
National Provider Identifier
1295458941
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
Legal business name
FOOT & WOUND CARE OF INDIO
Practice address
82013 Doctor Carreon Blvd Ste H
Indio, CA 92201-5832
Phone
(760) 610-8398
NPI assigned
Sep 19, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Authorized official

Name
Norris Donald MorrisonNPI 1790098218
Title
DPM
Phone
(951) 479-2915

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 Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0131X Primary

Addresses

Primary practice location

82013 Doctor Carreon Blvd Ste H
Indio, CA 92201-5832

Mailing address

7426 Cherry Ave Ste 210-123
Fontana, CA 92336-4221
Phone (760) 610-8398

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221018003198 CA Part B Supplier - Clinic/Group Practice 6901272830 Receives reassigned benefits from 5 practitioners
Practice locations: Indio, CA; Corona, CA; Apple Valley, CA

National Provider Directory

National Provider Directory

Locations

82013 Doctor Carreon Blvd
Ste H
Indio, CA 92201
Phone (760) 200-9909

Practitioners & affiliated clinicians

Practitioners 5

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": "1663545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663545600000",
    "number": "1295458941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7426 CHERRY AVE STE 210-123",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923364221",
            "telephone_number": "760-610-8398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82013 DOCTOR CARREON BLVD STE H",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015832",
            "telephone_number": "760-610-8398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & WOUND CARE OF INDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A",
        "authorized_official_last_name": "MORRISON",
        "authorized_official_first_name": "NORRIS",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "951-479-2915"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.