NPIMap

Organization Active NPI

Academy Foot and Ankle Specialists at Keller PLLC

  • Foot & Ankle Surgery Podiatrist
  • Keller, TX
National Provider Identifier
1346477304
Registry record updated Dec 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
1364 Issued in TX
Legal business name
ACADEMY FOOT AND ANKLE SPECIALISTS AT KELLER PLLC
Practice address
4444 Heritage Trace Pkwy
Suite 400
Keller, TX 76244-5378
Phone
(817) 424-3668
Fax
(817) 442-8637
NPI assigned
Jun 17, 2009
Last updated
Dec 12, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2016

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

Authorized official

Name
Paul Marciano, DPMNPI 1558321810
Title
Owner
Phone
(817) 424-3668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 1364 TX Primary

Addresses

Primary practice location

4444 Heritage Trace Pkwy
Suite 400
Keller, TX 76244-5378

Mailing address

1940 Highway 114
Suite 150
Southlake, TX 76092-6526
Phone (817) 424-3668

Other identifiers 1

IdentifierTypeStateIssuer
1346477304OtherNPI

National Provider Directory

National Provider Directory

Locations

4224 Heritage Trace Pkwy
Ste 300
Fort Worth, TX 76244
Phone (817) 741-4000

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": "1245196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481500800000",
    "number": "1346477304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 HIGHWAY 114",
            "address_2": "SUITE 150",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926526",
            "telephone_number": "817-424-3668",
            "fax_number": "817-442-8637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 HERITAGE TRACE PKWY",
            "address_2": "SUITE 400",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762445378",
            "telephone_number": "817-424-3668",
            "fax_number": "817-442-8637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADEMY FOOT AND ANKLE SPECIALISTS AT KELLER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-17",
        "last_updated": "2016-12-12",
        "status": "A",
        "authorized_official_last_name": "MARCIANO",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-424-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1346477304",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2016; 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.