Elite Podiatry, PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

0502 Issued in AZ

Legal business name

ELITE PODIATRY, PLLC

Practice address

13838 S 46TH PL
Suite 210
Phoenix, AZ 85044-7800

Phone

(480) 213-3011

Fax

(480) 816-4483

NPI assigned

Aug 30, 2010

Last updated

May 19, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Gregory Thomas Loo, DPMNPI 1659360485

Title

Owner

Phone

(602) 321-0292

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ2 enrollments

Enrollment records 2

Locations

Practitioners 1

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.

• Gregory T Loo, DPM

  • Podiatrist
  • Phoenix, AZ
  • NPI 1659360485
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1283126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463616000000",
    "number": "1366758104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13838 S 46TH PL",
            "address_2": "SUITE 210",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447800",
            "telephone_number": "480-213-3011",
            "fax_number": "480-816-4483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13838 S 46TH PL",
            "address_2": "SUITE 210",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850447800",
            "telephone_number": "480-213-3011",
            "fax_number": "480-816-4483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE PODIATRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-30",
        "last_updated": "2016-05-19",
        "status": "A",
        "authorized_official_last_name": "LOO",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-321-0292",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "0502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Foot & Ankle Surgery Podiatrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.