Foot Specialists of Tyler, PA

Primary specialty

PodiatristTaxonomy code 213E00000X

License

1375 Issued in TX

Legal business name

FOOT SPECIALISTS OF TYLER, PA

Practice address

649 S Broadway Ave
Suite 2
Tyler, TX 75701-1602

Phone

(903) 592-7200

Fax

(903) 592-7211

NPI assigned

Feb 12, 2007

Last updated

Nov 13, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Charles D Rhodus, DPMNPI 1962495341

Title

Owner

Phone

(903) 592-7200

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Tax ID family

Foot Specialists of Tyler PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Foot Specialists of Tyler, PA

  • Durable Medical Equipment & Medical Supplies
  • Tyler, TX
  • NPI 1114109170
  NPD tax ID

Locations

Practitioners 2

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.

• Charles Dale Rhodus, DPM

  • Podiatrist
  • Tyler, TX
  • NPI 1962495341
  Medicare reassignment Care Compare group NPD Authorized official
• Matthew Owen Kindle, DPM

  • Foot & Ankle Surgery Podiatrist
  • Tyler, TX
  • NPI 1891920583
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258070400000",
    "number": "1568504371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 S BROADWAY AVE",
            "address_2": "SUITE 2",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011602",
            "telephone_number": "903-592-7200",
            "fax_number": "903-592-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 S BROADWAY AVE",
            "address_2": "SUITE 2",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011602",
            "telephone_number": "903-592-7200",
            "fax_number": "903-592-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT SPECIALISTS OF TYLER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2009-11-13",
        "status": "A",
        "authorized_official_last_name": "RHODUS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "903-592-7200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "1375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0013PD",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DF6646",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186188201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Carroll Flynn, D.C.
• Megan Renee Followwell, PA-C
• Daniel Rush Folmer, LPC
• Foot Clinic of East Texas PC
• Foot Specialists of Tyler, PA
• Gerald P Foox, MD
• Ginger L Forbus
• Valery Forcha, PHARM.D
• Chiayrsh Ford, DO
• Christal Ford, BSN RN-BC

• Podiatrist in Tyler, TX
• Providers in Tyler, TX by specialty
• Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; 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.