NPIMap

Organization Active NPI

Ellsworth Foot and Ankle

  • Podiatrist
  • Park City, UT
National Provider Identifier
1295486116
Registry record updated Jan 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
ELLSWORTH FOOT AND ANKLE
Practice address
1678 Bonanza Dr
Park City, UT 84060-7201
Phone
(801) 253-6886
NPI assigned
Jan 12, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2022

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

Authorized official

Name
Allison Peck
Title
Credentialing Specialist
Phone
(801) 253-6886

Specialties & licenses 1

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

Addresses

Primary practice location

1678 Bonanza Dr
Park City, UT 84060-7201

Mailing address

9980 S 300 W Ste 310
Sandy, UT 84070-3654
Phone (801) 253-6886

National Provider Directory

National Provider Directory
Tax ID family
Ellsworth Foot and Ankle10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641945600000",
    "number": "1295486116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9980 S 300 W STE 310",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840703654",
            "telephone_number": "801-253-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1678 BONANZA DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607201",
            "telephone_number": "801-253-6886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLSWORTH FOOT AND ANKLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-01-12",
        "certification_date": "2022-01-12",
        "status": "A",
        "authorized_official_last_name": "PECK",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "801-253-6886"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2022; 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.