Prescott Foot & Ankle Clinic PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

0261AZ Issued in AZ

Legal business name

PRESCOTT FOOT & ANKLE CLINIC PC

Practice address

919 12TH Place
Suite 10
Prescott, AZ 86305-1433

Phone

(928) 776-0770

Fax

(928) 776-8991

NPI assigned

Nov 8, 2006

Last updated

Feb 8, 2008By 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

Kent L Peterson, DPMNPI 1316162647

Title

Owner

Phone

(928) 776-0770

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

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.

• Kent Lee Peterson, D.P.M.

  • Podiatrist
  • Prescott, AZ
  • NPI 1316162647
  Authorized official Same address or phone
• Kenneth Sherman Blocher, D.P.M.

  • Foot Surgery Podiatrist
  • Tucson, AZ
  • NPI 1992745327
  NPD (past)
• Scott R Price, DPM

  • Podiatrist
  • Prescott Valley, AZ
  • NPI 1417067455
  NPD (past)

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202428800000",
    "number": "1407925738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "919 12TH PLACE",
            "address_2": "SUITE 10",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051433",
            "telephone_number": "928-776-0770",
            "fax_number": "928-776-8991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "919 12TH PLACE",
            "address_2": "SUITE 10",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863051433",
            "telephone_number": "928-776-0770",
            "fax_number": "928-776-8991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESCOTT FOOT & ANKLE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-02-08",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-776-0770",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "0261AZ",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "700634",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Prescott Eye Care & Surgical Center PC
• Prescott Eye Care & Surgical Center, PC
• Prescott Family Chiropractic
• Prescott Family Medicine PLLC
• Prescott Family Practice and Wellness, LLC
• Prescott Gastroenterology
• Prescott Healthcare Solutions LLC (Optima Medical)
• Prescott Hearing LLC (A2Z Hearing Healthcare)
• Prescott House Inc
• Prescott House Treatment LLC

• Foot & Ankle Surgery Podiatrist in Prescott, AZ
• Providers in Prescott, 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 Feb 8, 2008; 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.