Active NPI
Foot & Ankle Specialists of Arizona PLLC
- Foot & Ankle Surgery Podiatrist
- Glendale, AZ
National Provider Identifier
1467072090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- Legal business name
- FOOT & ANKLE SPECIALISTS OF ARIZONA PLLC
- Practice address
- 5681 W Beverly LN Ste 100a
Glendale, AZ 85306-9800 - Phone
- (623) 544-9090
- Fax
- (623) 546-3704
- NPI assigned
- Apr 23, 2020
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Seth Clark, DPM
- Title
- Owner Provider
- Phone
- (623) 544-9090
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | Primary | ||
| Non-Pharmacy Dispensing Site | 332900000X |
Addresses
Primary practice location
5681 W Beverly LN Ste 100a
Glendale, AZ 85306-9800
Mailing address
18301 N 79TH Ave Ste F168
Glendale, AZ 85308-6045
Phone (623) 544-9090
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587600000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1712534400000",
"number": "1467072090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18301 N 79TH AVE STE F168",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853086045",
"telephone_number": "623-544-9090",
"fax_number": "623-546-3704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5681 W BEVERLY LN STE 100A",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853069800",
"telephone_number": "623-544-9090",
"fax_number": "623-546-3704"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOOT & ANKLE SPECIALISTS OF ARIZONA PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2020-04-23",
"last_updated": "2024-04-08",
"certification_date": "2024-04-08",
"status": "A",
"authorized_official_last_name": "CLARK",
"authorized_official_first_name": "SETH",
"authorized_official_title_or_position": "OWNER PROVIDER",
"authorized_official_telephone_number": "623-544-9090",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": null,
"license": null,
"primary": true
},
{
"code": "332900000X",
"taxonomy_group": "",
"desc": "Non-Pharmacy Dispensing Site",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Glendale, AZ
- Bradley John Folkestad, MD
- Erin Folsom, D.O.
- Theresia Fomeche
- Dianna Fontana, FNPC
- Foot & Ankle Specialists of Arizona PLLC
- Foot & Ankle Specialists of Arizona PLLC
- Footcare Center - Dr. Mark Gorman, PC
- Foothills Sports Medicine & Physical Therapy - Glendale LLC
- Foothills Sports Medicine & Physical Therapy - Stetson Village, LLC
- For the Community Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.