Organization Active NPI

Foot Doctor PC

  • Podiatrist
  • Phoenix, AZ
National Provider Identifier
1871624742
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
FOOT DOCTOR PC
Practice address
7000 N 16TH St # 120
Box 483
Phoenix, AZ 85020-5547
Phone
(602) 874-8566
Fax
(602) 395-1818
NPI assigned
Mar 9, 2007
Last updated
Mar 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Authorized official

Name
Karyn SallusNPI 1598752396
Title
Provider
Phone
(602) 874-8566

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

7000 N 16TH St # 120
Box 483
Phoenix, AZ 85020-5547

Mailing address

7000 N 16TH St # 120
Box 483
Phoenix, AZ 85020-5547
Phone (602) 874-8566

Other identifiers 1

IdentifierTypeStateIssuer
480030876OtherAZMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080428000412 AZ Part B Supplier - Clinic/Group Practice 2860570157 Receives reassigned benefits from 1 practitioner
Practice locations: Peoria, AZ; Phoenix, AZ; Scottsdale, AZ; Surprise, AZ; Tempe, AZ; Youngtown, AZ; Mesa, AZ; Apache Junction, AZ…

National Provider Directory

National Provider Directory

Locations

6735 W Hillcrest Blvd
Glendale, AZ 85310
Phone (623) 505-4660

8435 E McDowell Rd
Scottsdale, AZ 85257
Phone (480) 874-5300

Practitioners & affiliated clinicians

Practitioners 2

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": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332201600000",
    "number": "1871624742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 N 16TH ST # 120",
            "address_2": "BOX 483",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205547",
            "telephone_number": "602-874-8566",
            "fax_number": "602-395-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 N 16TH ST # 120",
            "address_2": "BOX 483",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850205547",
            "telephone_number": "602-874-8566",
            "fax_number": "602-395-1818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT DOCTOR PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2012-03-20",
        "status": "A",
        "authorized_official_last_name": "SALLUS",
        "authorized_official_first_name": "KARYN",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "602-874-8566"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "480030876",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.