Advanced Foot and Ankle Clinic PC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

Legal business name

ADVANCED FOOT AND ANKLE CLINIC PC

Practice address

3730 Plaza Way Ste 6500
Kennewick, WA 99338-2718

Phone

(509) 585-3622

Fax

(509) 585-3624

NPI assigned

Jan 9, 2007

Reactivated

May 2, 2008

Organization subpart

No

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

Authorized official

Name

Travis S Carter, DPMNPI 1134288533

Title

Owner

Phone

(509) 585-3622

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

Locations

Practitioners 2

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

• Travis S Carter, DPM

  • Podiatrist
  • Kennewick, WA
  • NPI 1134288533
  Medicare reassignment NPD Authorized official
• Samantha J Price, DPM

  • Foot & Ankle Surgery Podiatrist
  • Boone, NC
  • NPI 1578900106
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519776000000",
    "number": "1720137904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3730 PLAZA WAY STE 6500",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993382718",
            "telephone_number": "509-585-3622",
            "fax_number": "509-585-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3730 PLAZA WAY STE 6500",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993382718",
            "telephone_number": "509-585-3622",
            "fax_number": "509-585-3624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FOOT AND ANKLE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2018-02-28",
        "deactivation_date": "2007-10-31",
        "reactivation_date": "2008-05-02",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-585-3622",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "097343",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot & Ankle Surgery Podiatrist in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Foot & Ankle Surgery Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.