NPIMap

Organization Active NPI

Foot and Ankle Associates of the Desert

  • Foot & Ankle Surgery Podiatrist
  • Indio, CA
National Provider Identifier
1649487992
Registry record updated Aug 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
E4495 Issued in CA
Legal business name
FOOT AND ANKLE ASSOCIATES OF THE DESERT
Practice address
81709 Dr Carreon Blvd
Ste D3
Indio, CA 92201-5509
Phone
(760) 863-0070
Fax
(760) 863-0048
NPI assigned
May 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2009

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

Authorized official

Name
Dr. John E Ebaugh, DPM
Title
President
Phone
(760) 863-0070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X E4495 CA Primary

Addresses

Primary practice location

81709 Dr Carreon Blvd
Ste D3
Indio, CA 92201-5509

Mailing address

81709 Dr Carreon Blvd
Ste D3
Indio, CA 92201-5509
Phone (760) 863-0070

Other identifiers 1

IdentifierTypeStateIssuer
000E44950MedicaidCA

National Provider Directory

National Provider Directory

Locations

81709 Doctor Carreon Blvd
Ste D3
Indio, CA 92201
Phone (760) 863-0070

73660 El Paseo
Ste 5
Palm Desert, CA 92260
Phone (760) 674-3355

Practitioners & affiliated clinicians

Practitioners 5

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": "1179360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249603200000",
    "number": "1649487992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81709 DR CARREON BLVD",
            "address_2": "STE D3",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015509",
            "telephone_number": "760-863-0070",
            "fax_number": "760-863-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81709 DR CARREON BLVD",
            "address_2": "STE D3",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "922015509",
            "telephone_number": "760-863-0070",
            "fax_number": "760-863-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE ASSOCIATES OF THE DESERT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-17",
        "last_updated": "2009-08-07",
        "status": "A",
        "authorized_official_last_name": "EBAUGH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-863-0070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000E44950",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2009; 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.