Active NPI
Rio Grande Foot & Ankle Specialists LLC
- Foot & Ankle Surgery Podiatrist
- Santa Fe, NM
National Provider Identifier
1497364780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- Legal business name
- RIO GRANDE FOOT & ANKLE SPECIALISTS LLC
- Practice address
- 2019 Galisteo St Ste K-2
Santa Fe, NM 87505-2143 - Phone
- (505) 395-9575
- Fax
- (877) 540-1253
- NPI assigned
- Jul 23, 2020
- Organization subpart
- Yes
- Parent organization
- RIO GRANDE FOOT & ANKLE SPECIALISTS LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michelle Elizabeth Deithloff
- Title
- DPM/Owner
- Phone
- (505) 395-9575
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | Primary |
Addresses
Primary practice location
2019 Galisteo St Ste K-2
Santa Fe, NM 87505-2143
Mailing address
PO Box 540610
N Salt Lake, UT 84054-0610
Phone (801) 505-0821
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| POD401 | Other | NM | MEDICAL LICENSE |
Other names 1
- Rio Grande Foot & Ankle Specialists LLC
National Provider Directory
National Provider Directory- Part of
- Rio Grande Foot Ankle Specialists LLC
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Foot & Ankle Surgery Podiatrist
- Taos, NM
- NPI 1750938478
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595462400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1655078400000",
"number": "1497364780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 540610",
"city": "N SALT LAKE",
"state": "UT",
"postal_code": "840540610",
"telephone_number": "801-505-0821",
"fax_number": "801-505-0803"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2019 GALISTEO ST STE K-2",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875052143",
"telephone_number": "505-395-9575",
"fax_number": "877-540-1253"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "RIO GRANDE FOOT & ANKLE SPECIALISTS LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "RIO GRANDE FOOT & ANKLE SPECIALISTS LLC",
"enumeration_date": "2020-07-23",
"last_updated": "2022-06-13",
"certification_date": "2022-06-13",
"status": "A",
"authorized_official_last_name": "DEITHLOFF",
"authorized_official_first_name": "MICHELLE",
"authorized_official_middle_name": "ELIZABETH",
"authorized_official_title_or_position": "DPM/OWNER",
"authorized_official_telephone_number": "505-395-9575"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "POD401",
"state": "NM"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Rio Grande Foot & Ankle Specialists LLC",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Rio Grande Foot & Ankle Specialists LLC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.