NPIMap

Organization Active NPI

Salt Lake City Foot and Ankle Clinic, LLC

  • Foot & Ankle Surgery Podiatrist
  • Salt Lake City, UT
National Provider Identifier
1891037636
Registry record updated Nov 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
8425054-0501 Issued in UT
Legal business name
SALT LAKE CITY FOOT AND ANKLE CLINIC, LLC
Practice address
4578 S Highland Dr
St. 380
Salt Lake City, UT 84117-4243
Phone
(801) 274-9060
Fax
(801) 274-2126
NPI assigned
Mar 19, 2013
Last updated
Nov 26, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2013

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

Authorized official

Name
Christiaan Horst Goebel, DPMNPI 1659683381
Title
Podiatrist/Manager
Phone
(801) 274-9060

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
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 8425054-0501 UT Primary

Addresses

Primary practice location

4578 S Highland Dr
St. 380
Salt Lake City, UT 84117-4243

Mailing address

4578 S Highland Dr
St. 380
Salt Lake City, UT 84117-4243
Phone (801) 274-9060

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1363651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385424000000",
    "number": "1891037636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4578 S HIGHLAND DR",
            "address_2": "ST. 380",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174243",
            "telephone_number": "801-274-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4578 S HIGHLAND DR",
            "address_2": "ST. 380",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174243",
            "telephone_number": "801-274-9060",
            "fax_number": "801-274-2126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT LAKE CITY FOOT AND ANKLE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-11-26",
        "status": "A",
        "authorized_official_last_name": "GOEBEL",
        "authorized_official_first_name": "CHRISTIAAN",
        "authorized_official_middle_name": "HORST",
        "authorized_official_title_or_position": "PODIATRIST/MANAGER",
        "authorized_official_telephone_number": "801-274-9060",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "UT",
            "license": "8425054-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; 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.