White Mountain Foot and Ankle Care Center PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

640 Issued in AZ

Legal business name

WHITE MOUNTAIN FOOT AND ANKLE CARE CENTER PLLC

Practice address

5448 White Mountain Blvd
Suite 270
Lakeside, AZ 85929-5739

Phone

(928) 532-1122

Fax

(928) 532-1124

NPI assigned

Aug 16, 2007

Organization subpart

No

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

Authorized official

Name

H Ryan Hall, DPM

Title

President

Phone

(928) 367-3701

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 2

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

• Nanette Hall, FNP

  • Family Nurse Practitioner
  • Lakeside, AZ
  • NPI 1639827173
  Medicare reassignment Care Compare group NPD
• Hugh Ryan Hall, DPM

  • Foot & Ankle Surgery Podiatrist
  • Lakeside, AZ
  • NPI 1952352619
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229040000000",
    "number": "1508058249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 39",
            "city": "OVERGAARD",
            "state": "AZ",
            "postal_code": "859330039",
            "telephone_number": "928-532-1122",
            "fax_number": "928-532-1124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5448 WHITE MOUNTAIN BLVD",
            "address_2": "SUITE 270",
            "city": "LAKESIDE",
            "state": "AZ",
            "postal_code": "859295739",
            "telephone_number": "928-532-1122",
            "fax_number": "928-532-1124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE MOUNTAIN FOOT AND ANKLE CARE CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2008-12-12",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "H RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-367-3701",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087223",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• VCG Arizona LLC
• Matthew Waite
• Jonelle Wartenberg, PTA
• Steven D Washburn, M.D.
• White Mountain Family Practice Associates LTD
• White Mountain Hearing Services, LLC
• White Mountain Imaging, LLC
• White Mountain Medical Consultants LLC
• White Mountain Pediatrics, PC
• White Mountain Psychological Services, LTD

• Foot & Ankle Surgery Podiatrist in Lakeside, AZ
• Providers in Lakeside, AZ by specialty
• Foot & Ankle Surgery Podiatrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2008; 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.