Northwest Foot & Ankle

Primary specialty

PodiatristTaxonomy code 213E00000X

License

DP00317 Issued in OR

Legal business name

NORTHWEST FOOT & ANKLE

Practice address

725 NW 19TH Ave
Portland, OR 97209-1301

Phone

(503) 243-2699

Fax

(503) 243-2698

NPI assigned

Nov 24, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ray A McClanahan, DPMNPI 1124116231

Title

Owner

Phone

(503) 243-2699

Specialties & licenses 1

Addresses

Other identifiers 4

Tax ID family

Longview Foot Ankle Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Longview Foot & Ankle Clinic

  • Podiatrist
  • Longview, WA
  • NPI 1316032451
  NPD tax ID

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.

• Ray A McClanahan, DPM

  • Podiatrist
  • Beaverton, OR
  • NPI 1124116231
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1952477820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 NW 19TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091301",
            "telephone_number": "503-243-2699",
            "fax_number": "503-243-2698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 NW 19TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972091301",
            "telephone_number": "503-243-2699",
            "fax_number": "503-243-2698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST FOOT & ANKLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MCCLANAHAN",
        "authorized_official_first_name": "RAY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-243-2699",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP00317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480027978",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DSHS (MEDICAID)",
            "identifier": "208339",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1101682",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE RIDER",
            "identifier": "MC5942",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Northwest Extremity Specialists, LLC
• Northwest Eye Associates LLC
• Northwest Family Acupuncture
• Northwest Family Mental Health Services LLC
• Northwest Family Services
• Northwest Forensic Institute
• Northwest Gastroenterology Clinic LLC
• Northwest Habilitation Services, LLC
• Northwest Heart Care LLC
• Northwest in Home Healthcare Agency

• Podiatrist in Portland, OR
• Providers in Portland, OR by specialty
• Podiatrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.