Cascade Foot Clinic

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

License

DP00159 Issued in OR

Legal business name

CASCADE FOOT CLINIC

Practice address

2408 NE Division St
Bend, OR 97701-3543

Phone

(541) 382-7521

Fax

(541) 382-6297

NPI assigned

Jun 4, 2007

Last updated

Aug 28, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ambrose K Su, DPMNPI 1588649297

Title

Owner

Phone

(541) 382-7521

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR2 enrollments

Enrollment records 2

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ambrose K Su, DPM

  • Foot Surgery Podiatrist
  • Bend, OR
  • NPI 1588649297
  Medicare reassignment Care Compare group NPD Authorized official
• Victoria Faunce, FNP-BC

  • Family Nurse Practitioner
  • Bend, OR
  • NPI 1689319683
  Medicare reassignment Care Compare group NPD
• Amida Hair, DPM

  • Foot & Ankle Surgery Podiatrist
  • Bend, OR
  • NPI 1588217905
  Medicare reassignment NPD
• Tajyant Nat Chotechuang, DPM

  • Podiatrist
  • Bend, OR
  • NPI 1396757431
  NPD (past)
• Patrick J Evoy, DPM

  • Podiatrist
  • Bend, OR
  • NPI 1619951456
  NPD (past)
• Jeremy Dahlenburg, DPM

  • Foot & Ankle Surgery Podiatrist
  • Anchorage, AK
  • NPI 1982870721
  NPD (past)

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377648000000",
    "number": "1790987428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2408 NE DIVISION ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013543",
            "telephone_number": "541-382-7521",
            "fax_number": "541-382-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2408 NE DIVISION ST",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977013543",
            "telephone_number": "541-382-7521",
            "fax_number": "541-382-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASCADE FOOT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2013-08-28",
        "status": "A",
        "authorized_official_last_name": "SU",
        "authorized_official_first_name": "AMBROSE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "541-382-7521",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "OR",
            "license": "DP00128",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "OR",
            "license": "DP00159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cascade Child and Family Center (Cascade Child and Family Psychiatry)
• Cascade Compounding Center LLC
• Cascade Counseling and Family Services
• Cascade Crest Transitions
• Cascade Endodontic Group LLC
• Cascade Hand Therapy Inc
• Cascade Healthcare Community (Sage View at St. Charles Medical Center)
• Cascade Healthcare Community (St Charles Immediate Care Clinic)
• Cascade Healthcare Community Inc (NW High Desert Sleep Center Bend)
• Cascade in Home Care, LLC (Right at Home Central Oregon)

• Primary Podiatric Medicine Podiatrist in Bend, OR
• Providers in Bend, OR by specialty
• Primary Podiatric Medicine Podiatrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2013; 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.