Organization Active NPI

Ankle & Foot Center of Tampa Bay

  • Foot & Ankle Surgery Podiatrist
  • Tampa, FL
National Provider Identifier
1710157680
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
ANKLE & FOOT CENTER OF TAMPA BAY
Practice address
13389 N 56TH St BLDG J
Tampa, FL 33617-1161
Phone
(813) 989-2424
Fax
(813) 980-2932
NPI assigned
Mar 7, 2008
Last updated
Oct 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Authorized official

Name
Robert E Creighton, DPM
Title
Member
Phone
(813) 254-4747

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X
Primary Podiatric Medicine Podiatrist 213EP1101X
Foot & Ankle Surgery Podiatrist 213ES0103X Primary
Foot Surgery Podiatrist 213ES0131X

Addresses

Primary practice location

13389 N 56TH St BLDG J
Tampa, FL 33617-1161

Mailing address

2835 W de Leon St
Suite #101
Tampa, FL 33609-4130
Phone (813) 254-4747

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181106002131 FL DME Supplier - Physician - Podiatry 9133187107 Practice locations: Temple Terrace, FL

Other NPIs with the same Medicare PAC ID 6

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1710157680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 W DE LEON ST",
            "address_2": "SUITE #101",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336094130",
            "telephone_number": "813-254-4747",
            "fax_number": "813-254-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13389 N 56TH ST BLDG J",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336171161",
            "telephone_number": "813-989-2424",
            "fax_number": "813-980-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANKLE & FOOT CENTER OF TAMPA BAY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-07",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "CREIGHTON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "813-254-4747",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.