Magic Valley Foot and Ankle Specialists PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

CS35833 Issued in ID

Legal business name

MAGIC VALLEY FOOT AND ANKLE SPECIALISTS PLLC

Doing business as

Caleb Edwin Roberts Sole Mbr

Practice address

496 Shoup Ave W
Twin Falls, ID 83301-5834

Phone

(208) 709-1700

NPI assigned

Apr 21, 2014

Last updated

Jul 2, 2014By 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

Caleb Roberts, DPMNPI 1699062638

Title

Owner

Phone

(208) 709-1700

Specialties & licenses 1

Addresses

Other names 1

• Caleb Edwin Roberts Sole Mbr Doing business as

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

Locations

Practitioners 1

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.

• Caleb E Roberts, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Twin Falls, ID
  • NPI 1699062638
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1398038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404259200000",
    "number": "1609296326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SHOUP AVE W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015834",
            "telephone_number": "208-709-1700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 SHOUP AVE W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015834",
            "telephone_number": "208-709-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGIC VALLEY FOOT AND ANKLE SPECIALISTS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-21",
        "last_updated": "2014-07-02",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "CALEB",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-709-1700",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "ID",
            "license": "CS35833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Caleb Edwin Roberts Sole Mbr",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Magic Valley Anesthesiology Associates
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• Magic Valley Dental Anesthesia PLLC
• Magic Valley Denture Center Inc
• Magic Valley Family Practice, PLLC
• Magic Valley Kidney Institute LLP
• Magic Valley Medicine PLLC
• Magic Valley Medicine PLLC
• Magic Valley Oral Surgery
• Magic Valley Orthodontics PLLC

• Foot & Ankle Surgery Podiatrist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Foot & Ankle Surgery Podiatrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; 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.