Organization Active NPI

Flagstaff Foot and Ankle Specialists PC

  • Podiatrist
  • Flagstaff, AZ
National Provider Identifier
1689097198
Registry record updated May 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
0760 Issued in AZ
Legal business name
FLAGSTAFF FOOT AND ANKLE SPECIALISTS PC
Practice address
202 E Birch Ave
Flagstaff, AZ 86001-5246
Phone
(928) 226-7555
Fax
(928) 226-0014
NPI assigned
Feb 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2023

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

Authorized official

Name
Rachel O'Connor, DPMNPI 1770800740
Title
Owner/Podiatrist
Phone
(928) 226-7555

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 0760 AZ Primary

Addresses

Primary practice location

202 E Birch Ave
Flagstaff, AZ 86001-5246

Mailing address

202 E Birch Ave
Flagstaff, AZ 86001-5246
Phone (928) 226-7555

Other identifiers 1

IdentifierTypeStateIssuer
0760OtherAZPODIATRY LICENSE #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140508000217 AZ Part B Supplier - Clinic/Group Practice 6204069792 Receives reassigned benefits from 1 practitioner
Practice locations: Flagstaff, AZ
O20170125001312 AZ DME Supplier - Physician - Podiatry 6204069792 Practice locations: Flagstaff, AZ

National Provider Directory

National Provider Directory

Locations

202 E Birch Ave
Flagstaff, AZ 86001
Phone (928) 226-7555

Practitioners & affiliated clinicians

Practitioners 2

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": "1391472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683849600000",
    "number": "1689097198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E BIRCH AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860015246",
            "telephone_number": "928-226-7555",
            "fax_number": "928-226-0014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E BIRCH AVE",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860015246",
            "telephone_number": "928-226-7555",
            "fax_number": "928-226-0014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLAGSTAFF FOOT AND ANKLE SPECIALISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-04",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A",
        "authorized_official_last_name": "O'CONNOR",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_title_or_position": "OWNER/PODIATRIST",
        "authorized_official_telephone_number": "928-226-7555",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "AZ",
            "license": "0760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PODIATRY LICENSE #",
            "identifier": "0760",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2023; 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.