Organization Active NPI

Family Foot & Ankle Care of Jasper, PC

  • Foot Surgery Podiatrist
  • Jasper, IN
National Provider Identifier
1528484904
Registry record updated Feb 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
07001046A Issued in IN
Legal business name
FAMILY FOOT & ANKLE CARE OF JASPER, PC
Practice address
695 W 2ND St Ste C
Jasper, IN 47546
Phone
(812) 481-7200
Fax
(812) 481-7201
NPI assigned
Mar 10, 2014
Last updated
Feb 1, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2019

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

Authorized official

Name
Timothy Barry, DPMNPI 1558568493
Title
President
Phone
(812) 481-2741

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X 07001046A IN Primary

Addresses

Primary practice location

695 W 2ND St Ste C
Jasper, IN 47546

Mailing address

695 W 2ND St Ste C
Jasper, IN 47546-3240
Phone (812) 481-7200

Other practice location 1

721 W 13th St
Suite 205
Jasper, IN 47546-1817
Phone (812) 481-7200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140507001371 IN Part B Supplier - Clinic/Group Practice 6103059654 Receives reassigned benefits from 1 practitioner
Practice locations: French Lick, IN; Jasper, IN; Montgomery, IN; Washington, IN

National Provider Directory

National Provider Directory

Locations

721 W 13th St
Ste 205
Jasper, IN 47546
Phone (812) 481-7200

600 S State Road 57
Washington, IN 47501
Phone (812) 257-1052

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548979200000",
    "number": "1528484904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "695 W 2ND ST STE C",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475463240",
            "telephone_number": "812-481-7200",
            "fax_number": "812-481-7201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 W 2ND ST STE C",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "47546",
            "telephone_number": "812-481-7200",
            "fax_number": "812-481-7201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 W 13th St",
            "address_2": "Suite 205",
            "address_purpose": "LOCATION",
            "city": "Jasper",
            "state": "IN",
            "postal_code": "475461817",
            "country_code": "US",
            "telephone_number": "812-481-7200",
            "fax_number": "812-481-7201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FAMILY FOOT & ANKLE CARE OF JASPER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-10",
        "last_updated": "2019-02-01",
        "status": "A",
        "authorized_official_last_name": "BARRY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "812-481-2741",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "IN",
            "license": "07001046A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2019; 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.