NPIMap

Organization Active NPI

S. F. Hartley, D.P.M., P.C.

  • Foot & Ankle Surgery Podiatrist
  • Deer Park, TX
National Provider Identifier
1447442603
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
0691 Issued in TX
Legal business name
S. F. HARTLEY, D.P.M., P.C.
Practice address
112 W Pasadena Blvd
Deer Park, TX 77536-4870
Phone
(281) 479-5311
Fax
(281) 479-0748
NPI assigned
Aug 13, 2007
Last updated
Oct 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Authorized official

Name
Dr. Shirley Fred Hartley, D.P.M.NPI 1326001975
Title
Owner/ Practioner
Phone
28147985311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 0691 TX Primary

Addresses

Primary practice location

112 W Pasadena Blvd
Deer Park, TX 77536-4870

Mailing address

112 W Pasadena Blvd
Deer Park, TX 77536-4870
Phone (281) 479-5311

Other identifiers 3

IdentifierTypeStateIssuer
00F38EOtherTXBC/BS OF TEXAS
82J977OtherTXMEDICARE INDIVIDUAL #
82J977OtherTXBC/BS OF TEXAS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110120000789 TX Part B Supplier - Clinic/Group Practice 3173643236 Receives reassigned benefits from 3 practitioners
Practice locations: Houston, TX; Mont Belvieu, TX; Deer Park, TX

National Provider Directory

National Provider Directory

Locations

112 W Pasadena Blvd
Deer Park, TX 77536
Phone (281) 479-5311

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1186963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1447442603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 W PASADENA BLVD",
            "city": "DEER PARK",
            "state": "TX",
            "postal_code": "775364870",
            "telephone_number": "281-479-5311",
            "fax_number": "281-479-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 W PASADENA BLVD",
            "city": "DEER PARK",
            "state": "TX",
            "postal_code": "775364870",
            "telephone_number": "281-479-5311",
            "fax_number": "281-479-0748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "S. F. HARTLEY, D.P.M., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-13",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "HARTLEY",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_middle_name": "FRED",
        "authorized_official_title_or_position": "OWNER/ PRACTIONER",
        "authorized_official_telephone_number": "28147985311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "0691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF TEXAS",
            "identifier": "00F38E",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL #",
            "identifier": "82J977",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF TEXAS",
            "identifier": "82J977",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Deer Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2007; 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.