Organization Active NPI

Foot Ankle & Lower Leg Specialists

  • Foot & Ankle Surgery Podiatrist
  • San Jose, CA
National Provider Identifier
1912645250
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
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

Updated by the provider on Oct 26, 2022

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)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 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 Other name

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.