NPIMap

Organization Active NPI

Vafa Ferdowsian DPM, P.a.

Doing business as Foot and Ankle Specialty Clinic

  • Foot & Ankle Surgery Podiatrist
  • Conway, AR
National Provider Identifier
1922285147
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
230 Issued in AR
Legal business name
VAFA FERDOWSIAN DPM, P.A.
Doing business as
Foot and Ankle Specialty Clinic
Practice address
1120 Hogan LN Ste B
Conway, AR 72034-8216
Phone
(501) 327-3668
Fax
(501) 327-3664
NPI assigned
Jan 30, 2008
Last updated
Sep 4, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Authorized official

Name
Vafa N Ferdowsian, DPMNPI 1033182837
Title
Owner/Physician
Phone
(501) 327-3668

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0103X 230 AR Primary
Non-Pharmacy Dispensing Site 332900000X
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

1120 Hogan LN Ste B
Conway, AR 72034-8216

Mailing address

PO Box 10607
Conway, AR 72034-0010
Phone (501) 327-3668

Other names 1

  • Foot and Ankle Specialty Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110310001010 AR Part B Supplier - Clinic/Group Practice 7719182856 Receives reassigned benefits from 2 practitioners
Practice locations: Russellville, AR; Mountain Home, AR; Conway, AR; Benton, AR; Little Rock, AR

National Provider Directory

National Provider Directory

Locations

1120 Hogan Ln
Ste B
Conway, AR 72034
Phone (501) 327-3668

10319 W Markham St
Little Rock, AR 72205
Phone (501) 812-3947

10319 W Markham St
Ste 300
Little Rock, AR 72205
Phone (501) 209-4040

Practitioners & affiliated clinicians

Practitioners 3

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": "1201651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567555200000",
    "number": "1922285147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10607",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720340010",
            "telephone_number": "501-327-3668",
            "fax_number": "501-327-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 HOGAN LN STE B",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720348216",
            "telephone_number": "501-327-3668",
            "fax_number": "501-327-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAFA FERDOWSIAN DPM, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-30",
        "last_updated": "2019-09-04",
        "status": "A",
        "authorized_official_last_name": "FERDOWSIAN",
        "authorized_official_first_name": "VAFA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "501-327-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "AR",
            "license": "230",
            "primary": true
        },
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foot and Ankle Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Foot and Ankle Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2019; 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.