David T Ellsworth, D.P.M

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

0786 Issued in AZ

Practice address

4121 E Valley Auto Dr
Ste 110
Mesa, AZ 85206-4632

Phone

(480) 892-1540

Fax

(480) 892-2243

NPI assigned

Jul 7, 2011

Last updated

May 5, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ellsworth Foot and Ankle PLLC

  • Foot & Ankle Surgery Podiatrist
  • Mesa, AZ
  • NPI 1114389459
  Authorized official Same address or phone

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

{
    "created_epoch": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462406400000",
    "number": "1528355708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9233 E NEVILLE AVE",
            "address_2": "UNIT 1033",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852091505",
            "telephone_number": "480-310-6015",
            "fax_number": "480-892-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 E VALLEY AUTO DR",
            "address_2": "STE 110",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064632",
            "telephone_number": "480-892-1540",
            "fax_number": "480-892-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "DAVID",
        "middle_name": "T",
        "credential": "D.P.M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2016-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AZ",
            "license": "0786",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "0786",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "AZ",
            "license": "0786",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Ellis, MA, CCC-A
• Devin Alexander Ellis, LPC
• Ellsworth Foot and Ankle PLLC
• Ellsworth Physician Services
• Allison Ellsworth, LAMFT
• Elmo Sky LLC
• Christopher Elmore, MD
• Diane L. Elmore, M.D.
• Elmwood Group Homes
• Arthur William Elrey III, D.C.

• Foot & Ankle Surgery Podiatrist in Mesa, AZ
• Providers in Mesa, 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 May 5, 2016; 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.