NPIMap

Organization Active NPI

Evanston Family Foot Care

  • Foot & Ankle Surgery Podiatrist
  • Evanston, WY
National Provider Identifier
1700060902
Registry record updated Jan 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
127 Issued in WY
Legal business name
EVANSTON FAMILY FOOT CARE
Practice address
1565 Highway 150 South
Suite C
Evanston, WY 82930-5348
Phone
(307) 789-8997
Fax
(307) 789-2624
NPI assigned
Dec 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2008

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

Authorized official

Name
Dr. Jason Cannon Levitre, DPMNPI 1326017179
Title
Podiatrist
Phone
(307) 789-8997

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 PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 127 WY Primary

Addresses

Primary practice location

1565 Highway 150 South
Suite C
Evanston, WY 82930-5348

Mailing address

PO Box 238
Evanston, WY 82931-0238
Phone (307) 789-8997

Other identifiers 2

IdentifierTypeStateIssuer
DD8254OtherWYRAILROAD MEDICARE
1217844 00MedicaidWY

National Provider Directory

National Provider Directory

Locations

1565 State Highway 150 S
Ste C
Evanston, WY 82930
Phone (307) 789-8997

Practitioners & affiliated clinicians

Practitioners 1

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": "1198454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199577600000",
    "number": "1700060902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 238",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829310238",
            "telephone_number": "307-789-8997",
            "fax_number": "307-789-2624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 HIGHWAY 150 SOUTH",
            "address_2": "SUITE C",
            "city": "EVANSTON",
            "state": "WY",
            "postal_code": "829305348",
            "telephone_number": "307-789-8997",
            "fax_number": "307-789-2624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANSTON FAMILY FOOT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-24",
        "last_updated": "2008-01-06",
        "status": "A",
        "authorized_official_last_name": "LEVITRE",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "CANNON",
        "authorized_official_title_or_position": "PODIATRIST",
        "authorized_official_telephone_number": "307-789-8997",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WY",
            "license": "127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD8254",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1217844 00",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2008; 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.