NPIMap

Organization Active NPI

Utah Podiatry Group PC

Doing business as Advanced Foot And Ankle Center

  • Foot & Ankle Surgery Podiatrist
  • Park City, UT
National Provider Identifier
1679007819
Registry record updated Mar 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
95424340501 Issued in UT
Legal business name
UTAH PODIATRY GROUP PC
Doing business as
Advanced Foot And Ankle Center
Practice address
900 Round Valley Dr
Ste 120
Park City, UT 84060-7552
Phone
(801) 373-2499
Fax
(801) 373-5200
NPI assigned
Apr 14, 2017
Last updated
Mar 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2021

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

Authorized official

Name
Jared Dee McPhieNPI 1508151341
Title
DPM
Phone
(801) 373-2499

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
Foot & Ankle Surgery Podiatrist 213ES0103X 95424340501 UT Primary

Addresses

Primary practice location

900 Round Valley Dr
Ste 120
Park City, UT 84060-7552

Mailing address

PO Box 30015
Salt Lake City, UT 84130-0015
Phone (801) 451-6060

Other names 1

  • Advanced Foot And Ankle Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080530000369 UT Part B Supplier - Clinic/Group Practice 2163592379 Receives reassigned benefits from 15 practitioners
19 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Park City, UT; West Jordan, UT; South Ogden, UT; Sandy, UT; Salt Lake City, UT; Millcreek, UT; Highland, UT; Heber City, UT…

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

Locations

900 Round Valley Dr
Ste 120
Park City, UT 84060
Phone (435) 776-3499

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1492128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615420800000",
    "number": "1679007819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30015",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841300015",
            "telephone_number": "801-451-6060",
            "fax_number": "801-797-9154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 ROUND VALLEY DR",
            "address_2": "STE 120",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607552",
            "telephone_number": "801-373-2499",
            "fax_number": "801-373-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH PODIATRY GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-14",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-10",
        "status": "A",
        "authorized_official_last_name": "MCPHIE",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "DEE",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "801-373-2499"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "UT",
            "license": "95424340501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Foot And Ankle Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Foot And Ankle Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Park City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.