Advanced Foot and Ankle Associates PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

1916 Issued in TX

Legal business name

ADVANCED FOOT AND ANKLE ASSOCIATES PLLC

Practice address

6312 Azle Ave
Lake Worth, TX 76135-2442

Phone

(817) 238-8400

Fax

(817) 238-8401

NPI assigned

Jun 14, 2010

Last updated

Nov 28, 2023By 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. Russell Olin Pendleton, DPMNPI 1932356789

Title

Owner/Physician

Phone

(817) 238-8400

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX2 enrollments

Enrollment records 2

Tax ID family

Adv Foot Ankle Assoc PLLC2 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.

• Advanced Foot and Ankle Associates PLLC

  • Foot & Ankle Surgery Podiatrist
  • Saginaw, TX
  • NPI 1851602858
  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.

• Russell Pendleton, DPM

  • Foot & Ankle Surgery Podiatrist
  • Lake Worth, TX
  • NPI 1932356789
  Medicare reassignment Care Compare group NPD Authorized official
• Mark Thompson, DPM

  • Foot & Ankle Surgery Podiatrist
  • Lake Worth, TX
  • NPI 1750733119
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701129600000",
    "number": "1568783553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6312 AZLE AVE",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761352442",
            "telephone_number": "817-238-8400",
            "fax_number": "817-238-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6312 AZLE AVE",
            "city": "LAKE WORTH",
            "state": "TX",
            "postal_code": "761352442",
            "telephone_number": "817-238-8400",
            "fax_number": "817-238-8401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Crown Pointe Blvd Ste 240",
            "address_purpose": "LOCATION",
            "city": "Willow Park",
            "state": "TX",
            "postal_code": "760871192",
            "country_code": "US",
            "telephone_number": "817-400-2004",
            "fax_number": "888-843-5379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED FOOT AND ANKLE ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-14",
        "last_updated": "2023-11-28",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "PENDLETON",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "OLIN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "817-238-8400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1916",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS TX",
            "identifier": "0029WA",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218408702",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218408703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• M.Y. Abshir, PHARMD
• Affordable Dentures & Implants - Texas, PLLC
• Albertsons LLC (Albertsons Pharmacy #4150)
• Americross Transport
• Lydia Cecilia Ausberry, D.D.S.
• Arlene Slade Barnett, DDS

• Foot & Ankle Surgery Podiatrist in Lake Worth, TX
• Providers in Lake Worth, TX by specialty
• Foot & Ankle Surgery Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.