Boulder Foot & Ankle Center, LTD.

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

NV9807 Issued in NV

Legal business name

BOULDER FOOT & ANKLE CENTER, LTD.

Practice address

999 Adams Blvd
Ste 103
Boulder City, NV 89005-2244

Phone

(702) 293-5036

Fax

(866) 409-1683

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Wesley W Lyon, D.P.M.

Title

Owner

Phone

(702) 293-5036

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318377600000",
    "number": "1598890188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1344",
            "city": "OVERTON",
            "state": "NV",
            "postal_code": "890401344",
            "telephone_number": "702-293-5036",
            "fax_number": "866-409-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 ADAMS BLVD",
            "address_2": "STE 103",
            "city": "BOULDER CITY",
            "state": "NV",
            "postal_code": "890052244",
            "telephone_number": "702-293-5036",
            "fax_number": "866-409-1683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOULDER FOOT & ANKLE CENTER, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2011-10-12",
        "status": "A",
        "authorized_official_last_name": "LYON",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "702-293-5036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "NV",
            "license": "NV9807",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002102008",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480031437",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Podiatric Medicine Podiatrist in Boulder City, NV
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• Primary Podiatric Medicine Podiatrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.