Foot & Ankle Specialists of Arizona PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

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

Last updated

Apr 8, 2024By 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

Seth Clark, DPMNPI 1669811915

Title

Owner Provider

Phone

(623) 544-9090

Specialties & licenses 2

Addresses

Practitioners 1

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.

• Seth Clark, DPM

  • Podiatrist
  • Phoenix, AZ
  • NPI 1669811915
  Authorized official Same address or phone

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": []
}

• 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

• Foot & Ankle Surgery Podiatrist in Glendale, AZ
• Providers in Glendale, 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 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.

Verify at the official NPI Registry.