NPIMap

Organization Active NPI

Alderwood Ankle & Foot Clinic P.S.

  • Podiatric Clinic/Center
  • Lynnwood, WA
National Provider Identifier
1609065713
Registry record updated Jun 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
License
PO00000346 Issued in WA
Legal business name
ALDERWOOD ANKLE & FOOT CLINIC P.S.
Practice address
3500 188TH St SW Ste 110
Lynnwood, WA 98037-4757
Phone
(425) 778-5666
Fax
(425) 771-5374
NPI assigned
Oct 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2012

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

Authorized official

Name
Dr. Don B Floyd, DPMNPI 1639171333
Title
President
Phone
(425) 778-5666

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
Podiatric Clinic/Center 261QP1100X PO00000346 WA Primary

Addresses

Primary practice location

3500 188TH St SW Ste 110
Lynnwood, WA 98037-4757

Mailing address

3500 188TH St SW Ste 110
Lynnwood, WA 98037-4757
Phone (425) 778-5666

Other names 1

  • Lake Stevens Ankle & Foot Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040319001458 WA Part B Supplier - Clinic/Group Practice 5698665784 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: Lynnwood, WA; Lake Stevens, WA
O20100930098196 WA DME Supplier - Physician - Podiatry 5698665784 Practice locations: Lynnwood, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 4

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": "1192406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1609065713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 188TH ST SW STE 110",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374757",
            "telephone_number": "425-778-5666",
            "fax_number": "425-771-5374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 188TH ST SW STE 110",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980374757",
            "telephone_number": "425-778-5666",
            "fax_number": "425-771-5374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALDERWOOD ANKLE & FOOT CLINIC P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-15",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "FLOYD",
        "authorized_official_first_name": "DON",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-778-5666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "WA",
            "license": "PO00000346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Stevens Ankle & Foot Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; 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.