NPIMap

Organization Active NPI

Ellsworth Foot and Ankle Clinic

Doing business as Summit Foot and Ankle

  • Podiatrist
  • Vernal, UT
National Provider Identifier
1801187737
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
ELLSWORTH FOOT AND ANKLE CLINIC
Doing business as
Summit Foot and Ankle
Practice address
365 W 50 N Ste W1
Vernal, UT 84078-2010
Phone
(435) 789-2062
Fax
(801) 253-6888
NPI assigned
Apr 26, 2011
Last updated
Jul 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Authorized official

Name
Ryan Ellsworth, DPM
Title
Owner
Phone
(801) 253-6886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X Primary

Addresses

Primary practice location

365 W 50 N Ste W1
Vernal, UT 84078-2010

Mailing address

9980 S 300 W Ste 310
Sandy, UT 84070-3654
Phone (801) 253-6886

Other names 1

  • Summit Foot and Ankle Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Summit Foot and Ankle10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

175 N 100 W
Ste N104
Vernal, UT 84078
Phone (385) 236-3876

NPI Registry JSON

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656979200000",
    "number": "1801187737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9980 S 300 W STE 310",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840703654",
            "telephone_number": "801-253-6886",
            "fax_number": "385-900-5928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 W 50 N STE W1",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840782010",
            "telephone_number": "435-789-2062",
            "fax_number": "801-253-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLSWORTH FOOT AND ANKLE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-26",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A",
        "authorized_official_last_name": "ELLSWORTH",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-253-6886",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vernal, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.