Arkansas Foot Care Clinic, Inc

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

AR141 Issued in AR

Legal business name

ARKANSAS FOOT CARE CLINIC, INC

Practice address

2400 W Main St
Russellville, AR 72801-2531

Phone

(479) 890-3668

Fax

(479) 890-9513

NPI assigned

May 24, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer Aquilar

Title

Assistant Office Manager

Phone

(479) 970-2832

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Aquilar Foot Care Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in AR2 enrollments

Enrollment records 2

Locations

Practitioners 2

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

• Danny J Aquilar, DPM

  • Foot & Ankle Surgery Podiatrist
  • Russellville, AR
  • NPI 1699778407

  AR, Foot & Ankle Surgery

  Medicare reassignment NPD
• Vafa N Ferdowsian, DPM

  • Foot & Ankle Surgery Podiatrist
  • Conway, AR
  • NPI 1033182837

  Foot & Ankle Surgery

  NPD (past)

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1568465375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2089",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728112089",
            "telephone_number": "479-890-3668",
            "fax_number": "479-890-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 W MAIN ST",
            "city": "RUSSELLVILLE",
            "state": "AR",
            "postal_code": "728012531",
            "telephone_number": "479-890-3668",
            "fax_number": "479-890-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARKANSAS FOOT CARE CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "AQUILAR",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "ASSISTANT OFFICE MANAGER",
        "authorized_official_telephone_number": "479-970-2832",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AR",
            "license": "AR141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139915748",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE NUMBER",
            "identifier": "DE6137",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "5F442",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aquilar Foot Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Russellville, AR
• Foot & Ankle Surgery Podiatrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.