NPIMap

Organization Active NPI

Foot & Ankle Specialists of Arizona PLLC

  • Foot & Ankle Surgery Podiatrist
  • Glendale, AZ
National Provider Identifier
1871301424
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FOOT & ANKLE SPECIALISTS OF ARIZONA PLLC
Practice address
18301 N 79TH Ave Ste C130
Glendale, AZ 85308-8470
Phone
(623) 544-9090
Fax
(623) 546-3704
NPI assigned
Dec 27, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Authorized official

Name
Seth Clark, DPM
Title
Owner Provider
Phone
(623) 544-9090

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

18301 N 79TH Ave Ste C130
Glendale, AZ 85308-8470

Mailing address

18301 N 79TH Ave Ste F168
Glendale, AZ 85308-6045
Phone (623) 544-9090

National Provider Directory

National Provider Directory
Tax ID family
Foot Ankle Spec of Az PLLC6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1735257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1735603200000",
    "number": "1871301424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18301 N 79TH AVE STE F168",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853086045",
            "telephone_number": "623-544-9090",
            "fax_number": "623-546-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18301 N 79TH AVE STE C130",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853088470",
            "telephone_number": "623-544-9090",
            "fax_number": "623-546-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE SPECIALISTS OF ARIZONA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-27",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "SETH",
        "authorized_official_title_or_position": "OWNER PROVIDER",
        "authorized_official_telephone_number": "623-544-9090",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2024; 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.