Brockbank Foot & Ankle Clinic PC

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

License

356685-0501 Issued in UT

Legal business name

BROCKBANK FOOT & ANKLE CLINIC PC

Practice address

9690 S 1300 E Ste 120
Sandy, UT 84094-3798

Phone

(801) 501-4335

Fax

(801) 501-4338

NPI assigned

Jun 6, 2018

Last updated

Jun 6, 2018By 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

Dr. Greg Brockbank, DPMNPI 1710062849

Title

President

Phone

(509) 868-5865

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19164/brand/1/csg/1/fhir/r4

Practitioners 2

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.

• Greg R Brockbank, DPM

  • Podiatrist
  • Spokane, WA
  • NPI 1710062849

  UT

  Medicare reassignment NPD Authorized official
• Paul W Winterton, M.D.

  • Specialist
  • Draper, UT
  • NPI 1013963651
  NPD (past)

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528243200000",
    "number": "1952893703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9690 S 1300 E STE 120",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840943798",
            "telephone_number": "801-501-4335",
            "fax_number": "801-501-4338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9690 S 1300 E STE 120",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840943798",
            "telephone_number": "801-501-4335",
            "fax_number": "801-501-4338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROCKBANK FOOT & ANKLE CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-06-06",
        "status": "A",
        "authorized_official_last_name": "BROCKBANK",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-868-5865",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "UT",
            "license": "356685-0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David S Bridgeman, LMFT
• Brighton Pharmacy
• Cassandra Bringhurst
• Elizabeth Ann Brinton, PH. D., LMFT
• Jeanette Broberg
• Emily Rae Brons-Piche, DDS
• Shawn M Brooks, MD
• Devon Laine Brower, FNP-BC
• Alec Judd Brown, ED.S., M.S., PH.D.
• Isaac Brown, LCSW

• Podiatric Clinic/Center in Sandy, UT
• Providers in Sandy, UT by specialty
• Podiatric Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; 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.