Active NPI
Earl Dean McNabb, DPM
- Foot & Ankle Surgery Podiatrist
- Keizer, OR
National Provider Identifier
1487614509
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- DP00344
- Practice address
- 3625 River Rd N
#275
Keizer, OR 97303-5977 - Phone
- (503) 390-0959
- Fax
- (503) 390-1184
- NPI assigned
- Mar 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | DP00344 | OR | Primary |
Addresses
Primary practice location
3625 River Rd N
#275
Keizer, OR 97303-5977
Mailing address
PO Box 20367
Keizer, OR 97307-0367
Phone (503) 390-0959
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R133628 | Other | OR | MEDICARE KEIZER OFFICE |
| R118188 | Other | OR | MEDICARE MAC OFFICE |
| 182958 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200441600000",
"number": "1487614509",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 20367",
"city": "KEIZER",
"state": "OR",
"postal_code": "973070367",
"telephone_number": "503-390-0959",
"fax_number": "503-390-1184"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3625 RIVER RD N",
"address_2": "#275",
"city": "KEIZER",
"state": "OR",
"postal_code": "973035977",
"telephone_number": "503-390-0959",
"fax_number": "503-390-1184"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNABB",
"first_name": "EARL",
"middle_name": "DEAN",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-23",
"last_updated": "2008-01-16",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "OR",
"license": "DP00344",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE KEIZER OFFICE",
"identifier": "R133628",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE MAC OFFICE",
"identifier": "R118188",
"state": "OR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "182958",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Keizer, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.