Foot & Ankle Specialists of Idaho, P.C.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

P-223 Issued in ID

Legal business name

FOOT & ANKLE SPECIALISTS OF IDAHO, P.C.

Practice address

1277 E 17TH St
Idaho Falls, ID 83404-6126

Phone

(267) 644-6880

NPI assigned

Jun 16, 2014

Organization subpart

No

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

Authorized official

Name

Dr. John D Peterson, DPM

Title

Doctor of Podiatric Medicine

Phone

(208) 346-7443

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lynetta Ruth Hagler, LCSW

  • Mental Health Counselor
  • Idaho Falls, ID
  • NPI 1316110273
  NPD (past)
• Ronda Sue Knudsen, LPC

  • Mental Health Counselor
  • Idaho Falls, ID
  • NPI 1649444290
  NPD (past)
• Shon Lorin Shuldberg, LCSW

  • Mental Health Counselor
  • Idaho Falls, ID
  • NPI 1326212002
  NPD (past)

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

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410912000000",
    "number": "1437563699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1277 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046126",
            "telephone_number": "208-346-7443",
            "fax_number": "208-346-7442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1277 E 17TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046126",
            "telephone_number": "267-644-6880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE SPECIALISTS OF IDAHO, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-16",
        "last_updated": "2014-09-17",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DOCTOR OF PODIATRIC MEDICINE",
        "authorized_official_telephone_number": "208-346-7443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ID",
            "license": "P-223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fogg Drug Co Inc
• Alyssa Folker, M.S.
• Shelley Jo Folsom, WHNP-BC
• Austin Michal Fontes, LMSW
• Food Freedom Nutrition, LLC
• Foothills Dental Care
• Foothills Dental Care, PLLC
• Foothills Psychiatry and Addiction
• Foothills Rehabilitation & Performance Services
• Foothills Rehabilitation & Performance Services, PLLC

• Foot & Ankle Surgery Podiatrist in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Foot & Ankle Surgery Podiatrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.