NPIMap

Organization Active NPI

Summit Foot and Ankle Specialists

  • Podiatric Clinic/Center
  • Provo, UT
National Provider Identifier
1366819112
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Legal business name
SUMMIT FOOT AND ANKLE SPECIALISTS
Practice address
1355 N University Ave
Suite 125
Provo, UT 84604-2721
Phone
(801) 784-1111
NPI assigned
Aug 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2015

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

Authorized official

Name
Ryan Ellsworth
Title
Owner
Phone
(801) 784-1111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X Primary

Addresses

Primary practice location

1355 N University Ave
Suite 125
Provo, UT 84604-2721

Mailing address

1355 N University Ave
Suite 125
Provo, UT 84604-2721

National Provider Directory

National Provider Directory
Tax ID family
Summit Foot and Ankle Specialists4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440633600000",
    "number": "1366819112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 N UNIVERSITY AVE",
            "address_2": "SUITE 125",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 N UNIVERSITY AVE",
            "address_2": "SUITE 125",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846042721",
            "telephone_number": "801-784-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT FOOT AND ANKLE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-27",
        "last_updated": "2015-08-27",
        "status": "A",
        "authorized_official_last_name": "ELLSWORTH",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-784-1111"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; 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.