Medford Foot & Ankle Clinic, PC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

MEDFORD FOOT & ANKLE CLINIC, PC

Practice address

713 Golf View Drive
Medford, OR 97504-9643

Phone

(541) 770-1225

Fax

(541) 770-1245

NPI assigned

Sep 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Michael Andrew Dekorte, DPMNPI 1982795050

Title

Officer President

Phone

(541) 770-1225

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR2 enrollments

Enrollment records 2

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Andrew Dekorte, DPM

  • Podiatrist
  • Medford, OR
  • NPI 1982795050
  Medicare reassignment Care Compare group NPD Authorized official
• Ryan Arthur Mayberry, DPM

  • Foot & Ankle Surgery Podiatrist
  • Medford, OR
  • NPI 1952969347
  Medicare reassignment Care Compare group NPD
• Joshua Bracken Millward, DPM

  • Foot & Ankle Surgery Podiatrist
  • Medford, OR
  • NPI 1750901856
  Medicare reassignment Care Compare group NPD
• Jeffery Dale Zimmer, DPM

  • Podiatrist
  • Medford, OR
  • NPI 1588943708
  Medicare reassignment Care Compare group NPD
• Ricky Edward McClure, DPM

  • Podiatrist
  • Medford, OR
  • NPI 1255432530
  Medicare reassignment NPD
• Lynn William Rawcliffe, DPM

  • Foot & Ankle Surgery Podiatrist
  • Ashland, OR
  • NPI 1255439725
  NPD (past)
• Evan Chard Merrill, DPM

  • Foot Surgery Podiatrist
  • Meridian, ID
  • NPI 1528166485
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1508967886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 GOLF VIEW DRIVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049643",
            "telephone_number": "541-770-1225",
            "fax_number": "541-770-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 GOLF VIEW DRIVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975049643",
            "telephone_number": "541-770-1225",
            "fax_number": "541-770-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFORD FOOT & ANKLE CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "DEKORTE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OFFICER PRESIDENT",
        "authorized_official_telephone_number": "541-770-1225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240546",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BC",
            "identifier": "023677000",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Casandra Paige Medeiros, QMHA
• Medford Assisted Living LLC (The Orchards Assisted Living)
• Medford Dental Clinic, LLC
• Medford Ear Nose and Throat Clinic PC (Oregon Ear Nose and Throat Center)
• Medford Family Optical
• Medford Group Eyecare Incorporated (Group Eyecare)
• Medford Medical Clinic, LLP
• Medford Mobile Physical Therapy LLC
• Medford Neuro Clinic Inc
• Medford Nursing & Rehab Center LLC

• Podiatric Clinic/Center in Medford, OR
• Providers in Medford, OR by specialty
• Podiatric Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.