Organization Active NPI

Battle Ground Foot and Ankle

  • Podiatrist
  • Battle Ground, WA
National Provider Identifier
1295760122
Registry record updated Aug 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO00000795 Issued in WA
Legal business name
BATTLE GROUND FOOT AND ANKLE
Practice address
1710 W Main St Ste 221
Battle Ground, WA 98604-4317
Phone
(360) 687-3668
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2013

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

Authorized official

Name
Stephen Hayes, DPMNPI 1548254329
Title
Owner
Phone
(360) 687-3668

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X PO00000795 WA Primary

Addresses

Primary practice location

1710 W Main St Ste 221
Battle Ground, WA 98604-4317

Mailing address

1710 W Main St Ste 221
Battle Ground, WA 98604-4317
Phone (360) 687-3668

Other identifiers 2

IdentifierTypeStateIssuer
8481913MedicaidWA
7137821MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070213000057 WA Part B Supplier - Clinic/Group Practice 6406858190 Receives reassigned benefits from 3 practitioners
Practice locations: Battle Ground, WA
O20110706000149 WA DME Supplier - Physician - Podiatry 6406858190 Practice locations: Battle Ground, WA

National Provider Directory

National Provider Directory

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": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376956800000",
    "number": "1295760122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 W MAIN ST STE 221",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986044317",
            "telephone_number": "360-687-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 W MAIN ST STE 221",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986044317",
            "telephone_number": "360-687-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BATTLE GROUND FOOT AND ANKLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2013-08-20",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-687-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO00000795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8481913",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7137821",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Ground, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; 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.