NPIMap

Organization Active NPI

South Bay Foot & Ankle Specialists, Inc.

  • Podiatrist
  • Chula Vista, CA
National Provider Identifier
1689041055
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
SOUTH BAY FOOT & ANKLE SPECIALISTS, INC.
Practice address
345 F St
Ste 100
Chula Vista, CA 91910-2626
Phone
(619) 427-3481
Fax
(619) 420-7807
NPI assigned
Sep 1, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Authorized official

Name
John Chisholm, D.P.M.NPI 1396740072
Title
President
Phone
(619) 427-3481

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

345 F St
Ste 100
Chula Vista, CA 91910-2626

Mailing address

345 F St
Ste 100
Chula Vista, CA 91910-2626
Phone (619) 427-3481

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151019000757 CA Part B Supplier - Clinic/Group Practice 9638488448 Receives reassigned benefits from 7 practitioners
Practice locations: Chula Vista, CA; National City, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1441065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1689041055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 F ST",
            "address_2": "STE 100",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102626",
            "telephone_number": "619-427-3481",
            "fax_number": "619-420-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 F ST",
            "address_2": "STE 100",
            "city": "CHULA VISTA",
            "state": "CA",
            "postal_code": "919102626",
            "telephone_number": "619-427-3481",
            "fax_number": "619-420-7807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY FOOT & ANKLE SPECIALISTS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-01",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "CHISHOLM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-427-3481",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chula Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.