Sunrise Foot and Ankle LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

0307 Issued in NV

Legal business name

SUNRISE FOOT AND ANKLE LLC

Practice address

4580 S Eastern Ave Ste 30
Las Vegas, NV 89119-6100

Phone

(702) 731-3338

Fax

(702) 731-3341

NPI assigned

May 10, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Jeremy Wayne Wood, DPMNPI 1831159128

Title

Doctor

Phone

(702) 731-3338

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 3

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

• Jeremy Wayne Wood, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Las Vegas, NV
  • NPI 1831159128
  Medicare reassignment Care Compare group Authorized official
• James Alan Averett, DPM

  • Foot & Ankle Surgery Podiatrist
  • Las Vegas, NV
  • NPI 1598016255
  Medicare reassignment Care Compare group NPD
• Tyler Shane McAllister, DPM

  • Foot & Ankle Surgery Podiatrist
  • Las Vegas, NV
  • NPI 1427542513
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1304985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1508158536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4580 S EASTERN AVE STE 30",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196100",
            "telephone_number": "702-731-3338",
            "fax_number": "702-731-3341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4580 S EASTERN AVE STE 30",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891196100",
            "telephone_number": "702-731-3338",
            "fax_number": "702-731-3341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNRISE FOOT AND ANKLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-10",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "702-731-3338",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NV",
            "license": "0307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100503070",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Foot & Ankle Surgery Podiatrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; 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.