Organization Active NPI

Foot & Ankle Specialists of Arizona PLLC

  • Foot & Ankle Surgery Podiatrist
  • Glendale, AZ
National Provider Identifier
1467072090
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 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 Directory

NPI 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

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.

Verify at the official NPI Registry.