Ok Foot & Ankle Specialists

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

233 Issued in OK

Legal business name

OK FOOT & ANKLE SPECIALISTS

Practice address

9315 S Pennsylvania Ave
Ste a
Oklahoma City, OK 73159-6913

Phone

(405) 691-9004

Fax

(405) 691-9003

NPI assigned

Mar 1, 2007

Organization subpart

No

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

Authorized official

Name

Kari L. Johnson

Title

Billing/Credentialing

Phone

(405) 691-9004

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Oklahoma Foot and Ankle Specialists Doing business as

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeremy D. Gray, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Edmond, OK
  • NPI 1427206077

  Foot & Ankle Surgery

  NPD (past)
• Kimmie Phisaiwath, APRN-CNP

  • Family Nurse Practitioner
  • Oklahoma City, OK
  • NPI 1639662216
  NPD (past)

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492646400000",
    "number": "1619005865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9315 S PENNSYLVANIA AVE STE A",
            "address_2": "OKLAHOMA FOOT & ANKLE SPECIALISTS",
            "city": "OKC",
            "state": "OK",
            "postal_code": "731596913",
            "telephone_number": "405-691-9004",
            "fax_number": "405-691-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9315 S PENNSYLVANIA AVE",
            "address_2": "STE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596913",
            "telephone_number": "405-691-9004",
            "fax_number": "405-691-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OK FOOT & ANKLE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2017-04-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KARI",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "BILLING/CREDENTIALING",
        "authorized_official_telephone_number": "405-691-9004"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OK",
            "license": "233",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OK",
            "license": "289",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200034090B",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200330230A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oklahoma Foot and Ankle Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Foot & Ankle Surgery Podiatrist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2017; 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.