Organization Active NPI

Elk Grove Foot and Ankle PC

  • Podiatrist
  • Elk Grove, CA
National Provider Identifier
1558130369
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
ELK GROVE FOOT AND ANKLE PC
Practice address
5501 Castleford Way
Elk Grove, CA 95758-4766
Phone
(505) 980-9611
NPI assigned
Dec 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2023

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

Authorized official

Name
Dr. Christina Garvin, DPMNPI 1477840064
Title
Owner
Phone
(505) 980-9611

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

5501 Castleford Way
Elk Grove, CA 95758-4766

Mailing address

5501 Castleford Way
Elk Grove, CA 95758-4766
Phone (505) 980-9611

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240205004368 CA Part B Supplier - Clinic/Group Practice 1254774425 Receives reassigned benefits from 1 practitioner
Practice locations: Elk Grove, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1703116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703116800000",
    "number": "1558130369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 CASTLEFORD WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584766",
            "telephone_number": "505-980-9611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 CASTLEFORD WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957584766",
            "telephone_number": "505-980-9611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK GROVE FOOT AND ANKLE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A",
        "authorized_official_last_name": "GARVIN",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-980-9611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.