Nathan Brian Payne, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E5539 Issued in CA

Practice address

104 Margaret LN Ste a
Grass Valley, CA 95945-5261

Phone

(801) 368-0512

Fax

(530) 648-1235

NPI assigned

Mar 30, 2016

Last updated

Nov 26, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, UT, NE, ID4 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 4

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proactive Wound Care Id Inc.Group PAC ID 4082132139, 2 clinicians

Ryan K Anderson D P M P CGroup PAC ID 7517999121, 51 clinicians

Mountain West Podiatry LLCGroup PAC ID 7618348616, 6 clinicians

Proactive Wound Care NE IncGroup PAC ID 1759807977, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mountain West Podiatry LLC

  • Podiatrist
  • Centerville, UT
  • NPI 1235855669

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Proactive Wound Care NE Inc

  • Nurse Practitioner
  • Lincoln, NE
  • NPI 1134943780

  Single Specialty

  Medicare reassignment Care Compare group NPD Authorized official
• Proactive Wound Care Id Inc.

  • Podiatrist
  • Fish Haven, ID
  • NPI 1134928419

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Ryan K Anderson D P M P C

  dba Foot & Ankle Specialists of Utah

  • Foot & Ankle Surgery Podiatrist
  • Bountiful, UT
  • NPI 1639200215

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Valley Foot & Ankle Specialists

  • Foot & Ankle Surgery Podiatrist
  • Grass Valley, CA
  • NPI 1093374464

  Single Specialty

  Medicare reassignment NPD
• Mountain West Wound Care Inc

  • Nurse Practitioner
  • Centerville, UT
  • NPI 1083438626

  Single Specialty

  NPD Authorized official
• Fas Ms Iowa Physicians PLLC

  • Podiatrist
  • Johnston, IA
  • NPI 1043120397
  Authorized official Same address or phone
• Utah Podiatric Physicians and Surgeons Group LLC

  dba Utah Musculoskeletal Specialists

  • Podiatrist
  • Salt Lake City, UT
  • NPI 1720795586

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1760845473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 MARGARET LN STE A",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455261",
            "telephone_number": "801-368-0512",
            "fax_number": "530-648-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MARGARET LN STE A",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455261",
            "telephone_number": "801-368-0512",
            "fax_number": "530-648-1235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2333 Biddle Ave",
            "address_purpose": "LOCATION",
            "city": "Wyandotte",
            "state": "MI",
            "postal_code": "481924668",
            "country_code": "US",
            "telephone_number": "734-287-9029",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "NATHAN",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-30",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E5539",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MI",
            "license": "5315078221",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "GrassValley",
            "affiliation": "N",
            "address_1": "104 Margaret Ln Ste A",
            "city": "Grass Valley",
            "state": "CA",
            "country_code": "US",
            "postal_code": "959455261",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jay Robert Patt, DC
• Karina Maele Patton
• Marybeth Paul, CMT
• Samantha Paulus
• Mark H Paye, DDS
• Katrina Elaine Paz, LCSCW
• Peace of Mind TMS PC
• Pebble Beach Dental of Grass Valley
• Mitchell Jay Peck Eng, MS, CCC-SLP
• Amanda R Peebles, RADT

• Foot & Ankle Surgery Podiatrist in Grass Valley, CA
• Providers in Grass Valley, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.