Organization Active NPI

US Podiatry Group PLLC

  • Podiatrist
  • Arlington, TX
National Provider Identifier
1306684881
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
US PODIATRY GROUP PLLC
Practice address
1119 W Randol Mill Rd Ste 107
Arlington, TX 76012-6509
Phone
(817) 860-2700
Fax
(817) 860-2704
NPI assigned
Jul 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Authorized official

Name
Paul Nam Phong NguyenNPI 1336710136
Title
Doctor
Phone
(817) 860-2700

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 Primary

Addresses

Primary practice location

1119 W Randol Mill Rd Ste 107
Arlington, TX 76012-6509

Mailing address

1119 W Randol Mill Rd Ste 107
Arlington, TX 76012-6509
Phone (817) 860-2700

Other practice location 1

4320 S State Highway 360 Ste 300
Grand Prairie, TX 75052-7604
Phone (817) 860-2700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241023002197 TX Part B Supplier - Clinic/Group Practice 5395286694 Receives reassigned benefits from 1 practitioner
Practice locations: Arlington, TX; Grand Prairie, TX

National Provider Directory

National Provider Directory

Locations

1119 W Randol Mill Rd
Ste 105
Arlington, TX 76012
Phone (817) 422-9408

1119 W Randol Mill Rd
Ste 107
Arlington, TX 76012
Phone (817) 860-2700

4320 S State Highway 360
Ste 300
Grand Prairie, TX 75052
Phone (817) 860-2700

Practitioners & affiliated clinicians

Practitioners 2

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": "1721260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1306684881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 W RANDOL MILL RD STE 107",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760126509",
            "telephone_number": "817-860-2700",
            "fax_number": "817-860-2704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 W RANDOL MILL RD STE 107",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760126509",
            "telephone_number": "817-860-2700",
            "fax_number": "817-860-2704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4320 S State Highway 360 Ste 300",
            "address_purpose": "LOCATION",
            "city": "Grand Prairie",
            "state": "TX",
            "postal_code": "750527604",
            "country_code": "US",
            "telephone_number": "817-860-2700",
            "fax_number": "817-860-2704",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "US PODIATRY GROUP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-18",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "NAM PHONG",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "817-860-2700"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.