Organization Active NPI

Hill Country Advanced Foot and Ankle Center, P.a.

  • Foot & Ankle Surgery Podiatrist
  • Marble Falls, TX
National Provider Identifier
1467655845
Registry record updated Jun 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
HILL COUNTRY ADVANCED FOOT AND ANKLE CENTER, P.A.
Practice address
1001 Marble HTS
Marble Falls, TX 78654-4543
Phone
(830) 693-8144
Fax
(830) 693-8145
NPI assigned
Jun 6, 2007
Last updated
Jun 25, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2009

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

Authorized official

Name
Mr. Blake Everett Jamail
Title
Office Manager
Phone
(830) 693-8144

Specialties & licenses 1

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

Addresses

Primary practice location

1001 Marble HTS
Marble Falls, TX 78654-4543

Mailing address

1001 Marble HTS
Marble Falls, TX 78654-4543
Phone (830) 693-8144

Other identifiers 2

IdentifierTypeStateIssuer
1783805-01MedicaidTX
1467655845OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20051108000091 TX Part B Supplier - Clinic/Group Practice 4688692791 Receives reassigned benefits from 2 practitioners
Practice locations: Marble Falls, TX
O20100930016518 TX DME Supplier - Physician - Podiatry 4688692791 Practice locations: Marble Falls, TX

National Provider Directory

National Provider Directory
Tax ID family
Hill Country Advanced Foot and Ankle Center PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

623 S Washington St
Fredericksburg, TX 78624

1001 Marble Heights Dr
Marble Falls, TX 78654
Phone (830) 613-6442

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245888000000",
    "number": "1467655845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 MARBLE HTS",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786544543",
            "telephone_number": "830-693-8144",
            "fax_number": "830-693-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 MARBLE HTS",
            "city": "MARBLE FALLS",
            "state": "TX",
            "postal_code": "786544543",
            "telephone_number": "830-693-8144",
            "fax_number": "830-693-8145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILL COUNTRY ADVANCED FOOT AND ANKLE CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2009-06-25",
        "status": "A",
        "authorized_official_last_name": "JAMAIL",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "EVERETT",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "830-693-8144",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1783805-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1467655845",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marble Falls, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2009; 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.