Roanoke Foot & Ankle Institute, PLLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

ROANOKE FOOT & ANKLE INSTITUTE, PLLC

Doing business as

North Central Texas Foot & Ankle

Practice address

1713 S FM 51 Ste 103
Decatur, TX 76234-3644

Phone

(940) 627-0993

NPI assigned

Sep 30, 2020

Organization subpart

Yes

Parent organization

ROANOKE FOOT & ANKLE INSTITUTE, PLLCAs reported in NPPES

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

Authorized official

Name

Samantha Childers, DPMNPI 1790837425

Title

Managing Member

Phone

(415) 602-2048

Specialties & licenses 1

Addresses

Other names 1

• North Central Texas Foot & Ankle Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Roanoke Foot & Ankle Institute, PLLC

  • Foot & Ankle Surgery Podiatrist
  • Roanoke, TX
  • NPI 1497399687

  4981032992

  Same PAC ID

Part of

Roanoke Foot Ankle Institute PLLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Roanoke Foot & Ankle Institute, PLLC

  • Foot & Ankle Surgery Podiatrist
  • Roanoke, TX
  • NPI 1497399687
  NPPES parent name

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Samantha Childers, DPM

  • Foot & Ankle Surgery Podiatrist
  • Roanoke, TX
  • NPI 1790837425
  NPD Authorized official
• David Raj Chandra, DPM

  • Foot & Ankle Surgery Podiatrist
  • Decatur, TX
  • NPI 1689244766
  NPD
• Ricky L. Childers, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Decatur, TX
  • NPI 1396855458
  NPD
• Peter F Kelly, D.P.M.

  • Foot Surgery Podiatrist
  • Roanoke, VA
  • NPI 1114907458
  NPD (past)

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601424000000",
    "number": "1699382879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1224 N HIGHWAY 377 # 303-151",
            "city": "ROANOKE",
            "state": "TX",
            "postal_code": "762629103",
            "telephone_number": "817-674-7494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 S FM 51 STE 103",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343644",
            "telephone_number": "940-627-0993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROANOKE FOOT & ANKLE INSTITUTE, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ROANOKE FOOT & ANKLE INSTITUTE, PLLC",
        "enumeration_date": "2020-09-30",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "415-602-2048",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.athenanet.com",
            "affiliation": "N",
            "address_1": "1713 S Fm 51 Ste 103",
            "city": "Decatur",
            "state": "TX",
            "country_code": "US",
            "postal_code": "762343644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "North Central Texas Foot & Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John A Ribeiro, MD
• Brian Keith Rich, MD
• John W Richardson Jr., MD
• Eric Saxon Rieger, CRNA
• Syed Amir Rizvi, MD
• Kailey Jordan Robbins
• Tommy Joe Robinson Jr., L.O.
• Dale Roth Rodgers, ATC/LAT
• Renee Anne Romine, LCSW
• Samuel David Rosenbaum, DDS

• Foot & Ankle Surgery Podiatrist in Decatur, TX
• Providers in Decatur, TX by specialty
• Foot & Ankle Surgery Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2020; 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.