NPIMap

Organization Active NPI

Ankle & Foot Specialist of Puget Sound, PS

Doing business as Ankle & Foot Specialist of Bonney Lake

  • Podiatrist
  • Bonney Lake, WA
National Provider Identifier
1841578705
Registry record updated Mar 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO00000277 Issued in WA
Legal business name
ANKLE & FOOT SPECIALIST OF PUGET SOUND, PS
Doing business as
Ankle & Foot Specialist of Bonney Lake
Practice address
10004 204TH Ave E Ste 2700
Bonney Lake, WA 98391-6535
Phone
(253) 848-6656
NPI assigned
Jul 26, 2011
Last updated
Mar 26, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
ANKLE & FOOT SPECIALIST OF PUGET SOUND, PSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 26, 2012

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

Authorized official

Name
Charles R Chu, DPMNPI 1346235959
Title
Physician/Owner
Phone
(425) 449-2471

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO00000277 WA Primary

Addresses

Primary practice location

10004 204TH Ave E Ste 2700
Bonney Lake, WA 98391-6535

Mailing address

2728 E Main Ave Ste a
Puyallup, WA 98372-3198
Phone (253) 841-2006

Other names 1

  • Ankle & Foot Specialist of Bonney Lake Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040218000487 WA Part B Supplier - Clinic/Group Practice 7214822253 Receives reassigned benefits from 7 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Puyallup, WA; Redmond, WA; Issaquah, WA; Enumclaw, WA; Covington, WA; Bonney Lake, WA; Bellevue, WA

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Charles R Chu DPM PS12 organizations share this tax ID, including this one
Part of
Charles R Chu DPM PS

Other organizations with this tax ID 11

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

Locations

2728 E Main
Ste A
Puyallup, WA 98372
Phone (253) 841-2006

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.

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1311638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332720000000",
    "number": "1841578705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 E MAIN AVE STE A",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723198",
            "telephone_number": "253-841-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 204TH AVE E STE 2700",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983916535",
            "telephone_number": "253-848-6656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANKLE & FOOT SPECIALIST OF PUGET SOUND, PS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANKLE & FOOT SPECIALIST OF PUGET SOUND, PS",
        "enumeration_date": "2011-07-26",
        "last_updated": "2012-03-26",
        "status": "A",
        "authorized_official_last_name": "CHU",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "425-449-2471",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO00000277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ankle & Foot Specialist of Bonney Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bonney Lake, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2012; 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.