Active NPI
Foot Ankle & Lower Leg Specialists
- Foot & Ankle Surgery Podiatrist
- San Jose, CA
National Provider Identifier
1912645250
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- Legal business name
- FOOT ANKLE & LOWER LEG SPECIALISTS
- Practice address
- 660 E Santa Clara St
San Jose, CA 95112-1931 - Phone
- (669) 977-0200
- Fax
- (669) 333-3310
- NPI assigned
- May 26, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Yilma Kebede Kebelo, MD, DPM
- Title
- President
- Phone
- (408) 829-2904
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | Primary |
Addresses
Primary practice location
660 E Santa Clara St
San Jose, CA 95112-1931
Mailing address
660 E Santa Clara St
San Jose, CA 95112-1931
Phone (669) 977-0200
Other practice location 1
2828 H St
Bakersfield, CA 93301-1900
Phone (661) 337-2950
Other names 1
- FOOT ANKLE & LOWER LEG SPECIALISTS
National Provider Directory
National Provider DirectoryLocations
2828 H St
Bakersfield, CA 93301
Phone (661) 337-2950
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653523200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1666742400000",
"number": "1912645250",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "660 E SANTA CLARA ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951121931",
"telephone_number": "669-977-0200",
"fax_number": "669-333-3310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "660 E SANTA CLARA ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951121931",
"telephone_number": "669-977-0200",
"fax_number": "669-333-3310"
}
],
"practiceLocations": [
{
"address_1": "2828 H St",
"address_purpose": "LOCATION",
"city": "Bakersfield",
"state": "CA",
"postal_code": "933011900",
"country_code": "US",
"telephone_number": "661-337-2950",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "FOOT ANKLE & LOWER LEG SPECIALISTS",
"organizational_subpart": "NO",
"enumeration_date": "2022-05-26",
"last_updated": "2022-10-26",
"certification_date": "2022-10-26",
"status": "A",
"authorized_official_last_name": "KEBELO",
"authorized_official_first_name": "YILMA",
"authorized_official_middle_name": "KEBEDE",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "408-829-2904",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD, DPM"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "FOOT ANKLE & LOWER LEG SPECIALISTS",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "FOOT ANKLE & LOWER LEG SPECIALISTS",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in San Jose, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.