Organization Active NPI

Jerry W. Patterson, D.P.M, P.a.

  • Foot Surgery Podiatrist
  • San Antonio, TX
National Provider Identifier
1326308305
Registry record updated May 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
0457 Issued in TX
Legal business name
JERRY W. PATTERSON, D.P.M, P.A.
Practice address
423 Treeline Park
Suite 315
San Antonio, TX 78209-2060
Phone
(210) 614-9610
Fax
(210) 614-9613
NPI assigned
May 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2012

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

Authorized official

Name
Elizabeth Ardoin
Title
Billing Manager
Phone
(210) 614-9610

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X 0457 TX Primary

Addresses

Primary practice location

423 Treeline Park
Suite 315
San Antonio, TX 78209-2060

Mailing address

423 Treeline Park
Suite 315
San Antonio, TX 78209-2060
Phone (210) 614-9610

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120806000818 TX Part B Supplier - Clinic/Group Practice 6901052042 Receives reassigned benefits from 2 practitioners
Practice locations: San Antonio, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1337731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337731200000",
    "number": "1326308305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "423 TREELINE PARK",
            "address_2": "SUITE 315",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782092060",
            "telephone_number": "210-614-9610",
            "fax_number": "210-614-9613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "423 TREELINE PARK",
            "address_2": "SUITE 315",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782092060",
            "telephone_number": "210-614-9610",
            "fax_number": "210-614-9613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY W. PATTERSON, D.P.M, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-05-23",
        "status": "A",
        "authorized_official_last_name": "ARDOIN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "210-614-9610"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "TX",
            "license": "0457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.