Organization Active NPI

Sedona Foot & Ankle Specialists P C

  • Primary Podiatric Medicine Podiatrist
  • Cottonwood, AZ
National Provider Identifier
1477500155
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
Legal business name
SEDONA FOOT & ANKLE SPECIALISTS P C
Practice address
401 S Calvary Way
Ste a
Cottonwood, AZ 86326-4169
Phone
(928) 282-3305
Fax
(928) 282-6816
NPI assigned
May 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Authorized official

Name
Serjik Nazarian, DPMNPI 1215994561
Title
Provider
Phone
(928) 282-3305

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
Primary Podiatric Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213EP1101X Primary

Addresses

Primary practice location

401 S Calvary Way
Ste a
Cottonwood, AZ 86326-4169

Mailing address

401 S Calvary Way
Ste a
Cottonwood, AZ 86326-4169
Phone (928) 282-3305

Other identifiers 1

IdentifierTypeStateIssuer
149262MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040611001342 AZ Part B Supplier - Clinic/Group Practice 8527041284 Receives reassigned benefits from 1 practitioner
Practice locations: Cottonwood, AZ; Prescott, AZ
O20100930022838 AZ DME Supplier - Physician - Podiatry 8527041284 Practice locations: Cottonwood, AZ

National Provider Directory

National Provider Directory

Locations

105 Roadrunner Dr
Ste 3
Sedona, AZ 86336
Phone (602) 282-3305

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694736000000",
    "number": "1477500155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S CALVARY WAY",
            "address_2": "STE A",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264169",
            "telephone_number": "928-282-3305",
            "fax_number": "928-282-6816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S CALVARY WAY",
            "address_2": "STE A",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264169",
            "telephone_number": "928-282-3305",
            "fax_number": "928-282-6816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEDONA FOOT & ANKLE SPECIALISTS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "NAZARIAN",
        "authorized_official_first_name": "SERJIK",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "928-282-3305",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149262",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.