NPIMap

Organization Active NPI

Ellsworth Foot and Ankle Clinic

Doing business as Summit Foot and Ankle

  • Podiatrist
  • Provo, UT
National Provider Identifier
1932878030
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
ELLSWORTH FOOT AND ANKLE CLINIC
Doing business as
Summit Foot and Ankle
Practice address
3355 N University Ave Ste 175
Provo, UT 84604-6620
Phone
(801) 253-6886
Fax
(801) 253-6888
NPI assigned
Sep 10, 2021
Last updated
Feb 5, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
ELLSWORTH FOOT AND ANKLE CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Authorized official

Name
Ryan Ellsworth, DPM
Title
Owner
Phone
(801) 253-6886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X NU Primary

Addresses

Primary practice location

3355 N University Ave Ste 175
Provo, UT 84604-6620

Mailing address

9980 S 300 W Ste 300
Sandy, UT 84070-3654
Phone (801) 253-6886

Other names 1

  • Summit Foot and Ankle Doing business as

National Provider Directory

National Provider Directory
Part of
Ellsworth Foot and Ankle Clinic

Locations

505 Fairburn Rd SW
Ste 100
Atlanta, GA 30331
Phone (404) 618-6077

95 White Sage Ave
Delta, UT 84624
Phone (435) 864-2551

3130 S Highland Dr
Millcreek, UT 84106

365 W 50 N
Ste W1
Vernal, UT 84078
Phone (435) 789-2062

Practitioners & affiliated clinicians

Practitioners 7

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": "1631232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738713600000",
    "number": "1932878030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9980 S 300 W STE 300",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840703654",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 N UNIVERSITY AVE STE 175",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046620",
            "telephone_number": "801-253-6886",
            "fax_number": "801-253-6888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLSWORTH FOOT AND ANKLE CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ELLSWORTH FOOT AND ANKLE CLINIC",
        "enumeration_date": "2021-09-10",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A",
        "authorized_official_last_name": "ELLSWORTH",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-253-6886",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summit Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.