NPIMap

Organization Active NPI

Community Foundation Medical Group

Doing business as Sante' Foundation Medical Group

  • Foot & Ankle Surgery Podiatrist
  • Clovis, CA
National Provider Identifier
1821761743
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
COMMUNITY FOUNDATION MEDICAL GROUP
Doing business as
Sante' Foundation Medical Group
Practice address
1516 Shaw Ave
Clovis, CA 93611-4028
Phone
(559) 228-5400
NPI assigned
Jul 27, 2021
Last updated
Feb 14, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY FOUNDATION MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Authorized official

Name
Mr. Scott B Wells
Title
Ceo/President
Phone
(559) 228-5429

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X
Foot & Ankle Surgery Podiatrist 213ES0103X Primary
Foot Surgery Podiatrist 213ES0131X

Addresses

Primary practice location

1516 Shaw Ave
Clovis, CA 93611-4028

Mailing address

PO Box 28949
Fresno, CA 93729-8949
Phone (559) 228-5400

Other practice location 1

7370 N Palm Ave Ste 101
Fresno, CA 93711-5782
Phone (559) 228-5400

Other names 1

  • Sante' Foundation Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210928000533 CA DME Supplier - Physician - Podiatry 0345406294 Practice locations: Clovis, CA

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Community Fndtn Med GRP3 organizations share this tax ID, including this one
Part of
Community Fndtn Med GRP

Other organizations with this tax ID 2

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

Locations

1516 Shaw Ave
Clovis, CA 93611
Phone (559) 228-5400

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1627344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644796800000",
    "number": "1821761743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28949",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937298949",
            "telephone_number": "559-228-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 SHAW AVE",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936114028",
            "telephone_number": "559-228-5400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7370 N Palm Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937115782",
            "country_code": "US",
            "telephone_number": "559-228-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COMMUNITY FOUNDATION MEDICAL GROUP",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY FOUNDATION MEDICAL GROUP",
        "enumeration_date": "2021-07-27",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-02",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "559-228-5429",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sante' Foundation Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Sante' Foundation Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clovis, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.