Central Utah Foot Clinic, LLC

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

License

102652-0501 Issued in UT

Legal business name

CENTRAL UTAH FOOT CLINIC, LLC

Practice address

120 N 1220 E
Ste 12
American Fork, UT 84003-2089

Phone

(801) 756-4200

Fax

(801) 756-8252

NPI assigned

Sep 20, 2012

Organization subpart

No

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

Authorized official

Name

Mark Rogers

Title

Owner

Phone

(801) 756-4200

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Central Utah Foot Clinic LL3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Central Utah Foot Clinic, LLC

  • Foot & Ankle Surgery Podiatrist
  • Saratoga Springs, UT
  • NPI 1750633558
  NPD tax ID
• Central Utah Foot Clinic, LLC

  • Foot & Ankle Surgery Podiatrist
  • Provo, UT
  • NPI 1881729507
  NPD tax ID

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

{
    "created_epoch": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1881945608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N 1220 E",
            "address_2": "STE 12",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032089",
            "telephone_number": "801-756-4200",
            "fax_number": "801-756-8252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N 1220 E",
            "address_2": "STE 12",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032089",
            "telephone_number": "801-756-4200",
            "fax_number": "801-756-8252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL UTAH FOOT CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-756-4200"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "UT",
            "license": "102652-0501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1881729507",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marilee Castro, MS CCC-SLP
• Judy E Ceccherini, LMFT
• Central Utah Clinic, P.C.
• Central Utah Clinic, P.C.
• Central Utah Clinic, P.C.
• Central Utah Optical
• Clarisse Marie Chadwick, LPC
• Sadey Jo Chadwick, FNP
• Laurie Lynne Chamberlain
• Monica Chamberlain

• Foot Surgery Podiatrist in American Fork, UT
• Providers in American Fork, UT by specialty
• Foot Surgery Podiatrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.