North Central Texas Foot & Ankle, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

1932 Issued in TX

Legal business name

NORTH CENTRAL TEXAS FOOT & ANKLE, LLC

Practice address

1713 S FM 51
Suite 103
Decatur, TX 76234-3642

Phone

(940) 627-6976

Fax

(940) 627-3491

NPI assigned

Dec 31, 2013

Organization subpart

No

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

Authorized official

Name

Ricky Childers

Title

Officer

Phone

(415) 730-5058

Specialties & licenses 1

Addresses

Other identifiers 2

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Methodist Surgery Center - Keller, LLC

  • Ambulatory Surgical Clinic/Center
  • Keller, TX
  • NPI 1396559951

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1388448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559606400000",
    "number": "1811318330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 S FM 51",
            "address_2": "SUITE 103",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343642",
            "telephone_number": "940-627-6976",
            "fax_number": "940-627-3491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 S FM 51",
            "address_2": "SUITE 103",
            "city": "DECATUR",
            "state": "TX",
            "postal_code": "762343642",
            "telephone_number": "940-627-6976",
            "fax_number": "940-627-3491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH CENTRAL TEXAS FOOT & ANKLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-31",
        "last_updated": "2019-06-04",
        "status": "A",
        "authorized_official_last_name": "CHILDERS",
        "authorized_official_first_name": "RICKY",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "415-730-5058"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "TX",
            "license": "1932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "0039ZP",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "334277601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaison Ninan, PA-C
• Tyler James Noble, CPHT
• Robin Nobles, LPC-A
• North Central Texas Advanced Neurology PA
• North Central Texas Family Medicine PA
• North Central Texas Podiatry, PA
• North Texas Area Community Health Centers, Inc.
• North Texas Companion Care
• NTSS Inc
• NTSS-Pma PLLC

• Foot & Ankle Surgery Podiatrist in Decatur, TX
• Providers in Decatur, TX by specialty
• Foot & Ankle Surgery Podiatrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; 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.