NPIMap

Organization Active NPI

Glacier Podiatry Clinics LLC

  • Primary Podiatric Medicine Podiatrist
  • Edmond, OK
National Provider Identifier
1508117698
Registry record updated Sep 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
125 Issued in OK
Legal business name
GLACIER PODIATRY CLINICS LLC
Practice address
416 W 15TH St
Suite 400B
Edmond, OK 73013-3747
Phone
(405) 285-8900
Fax
(405) 285-8921
NPI assigned
Sep 28, 2012
Organization subpart
Yes
Parent organization
GLACIER HEALTHCARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 28, 2012

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

Authorized official

Name
Mr. Chad E Huffmyer
Title
President
Phone
(405) 285-8900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213EP1101X 125 OK Primary

Addresses

Primary practice location

416 W 15TH St
Suite 400B
Edmond, OK 73013-3747

Mailing address

416 W 15TH St
Suite 400B
Edmond, OK 73013-3747
Phone (405) 285-8900

National Provider Directory

National Provider Directory
Part of
Glacier Healthcare LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

416 W 15th St
Ste 400B
Edmond, OK 73013
Phone (405) 285-8900

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.

Practitioners & affiliated clinicians

Practitioners 3

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": "1348790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348790400000",
    "number": "1508117698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 W 15TH ST",
            "address_2": "SUITE 400B",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133747",
            "telephone_number": "405-285-8900",
            "fax_number": "405-285-8921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 W 15TH ST",
            "address_2": "SUITE 400B",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730133747",
            "telephone_number": "405-285-8900",
            "fax_number": "405-285-8921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLACIER PODIATRY CLINICS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GLACIER HEALTHCARE LLC",
        "enumeration_date": "2012-09-28",
        "last_updated": "2012-09-28",
        "status": "A",
        "authorized_official_last_name": "HUFFMYER",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "405-285-8900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "OK",
            "license": "125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.