Valley Foot & Ankle, PC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

P92 Issued in ID

Legal business name

VALLEY FOOT & ANKLE, PC

Practice address

1455 Bench Rd Ste B
Pocatello, ID 83201-5084

Phone

(208) 232-0006

Fax

(208) 232-0006

NPI assigned

Feb 20, 2007

Last updated

Mar 17, 2018By 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

Dr. Brandon Dean Wilde, DPMNPI 1407169865

Title

Owner/Practioner

Phone

(208) 232-0006

Specialties & licenses 1

Addresses

Other identifiers 3

Tax ID family

Valley Foot and Ankle PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Valley Foot & Ankle, PC

  • Podiatrist
  • Preston, ID
  • NPI 1154238319
  NPD tax ID
• Valley Foot & Ankle, PC

  • Podiatrist
  • Pocatello, ID
  • NPI 1790864619
  NPD tax ID

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.

• Brandon D Wilde, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Pocatello, ID
  • NPI 1407169865
  NPD Authorized official

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1669516738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 BENCH RD STE B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015084",
            "telephone_number": "208-232-0006",
            "fax_number": "208-233-8771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 BENCH RD STE B",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015084",
            "telephone_number": "208-232-0006",
            "fax_number": "208-232-0006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1155 Pocatello Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832012949",
            "country_code": "US",
            "telephone_number": "208-232-0006",
            "fax_number": "208-233-8771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VALLEY FOOT & ANKLE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "WILDE",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "OWNER/PRACTIONER",
        "authorized_official_telephone_number": "208-232-0006",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "ID",
            "license": "P92",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000806000",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804267100",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806528400",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander G Urfer, PT
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• Jason Valenzuela
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• Valley Foot & Ankle, PC
• Valley View Anesthesia PA
• Valley View Health Services, Inc. (Monte Vista Hills Healthcare Center Outpatient Therapy)
• Valley View Health Services, Inc. (Monte Vista Hills Healthcare Center)
• Janellie Valmaceda

• Podiatrist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Podiatrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.