Organization Active NPI

Stevens Foot & Ankle LLP

  • Podiatrist
  • Edmonds, WA
National Provider Identifier
1962531764
Registry record updated Jan 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POOOOOO411 Issued in WA
Legal business name
STEVENS FOOT & ANKLE LLP
Practice address
7315 212TH St SW Ste 103
Edmonds, WA 98026-7610
Phone
(425) 775-6996
Fax
(425) 670-8905
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2008

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

Authorized official

Name
Dr. Darren J. Wardle, DPM
Title
Owner
Phone
(425) 775-6996

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X POOOOOO411 WA Primary

Addresses

Primary practice location

7315 212TH St SW Ste 103
Edmonds, WA 98026-7610

Mailing address

PO Box 11009
Olympia, WA 98508-1009
Phone (425) 775-6996

Other identifiers 4

IdentifierTypeStateIssuer
7094816MedicaidWA
ST5742OtherREGENCE RIDER
0124633OtherWAL AND I
CH7422OtherMEDICARE RR

National Provider Directory

National Provider Directory

Locations

7315 212th St SW
Ste 103
Edmonds, WA 98026
Phone (425) 775-6996

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1962531764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11009",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985081009",
            "telephone_number": "425-775-6996",
            "fax_number": "425-670-8905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7315 212TH ST SW STE 103",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980267610",
            "telephone_number": "425-775-6996",
            "fax_number": "425-670-8905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEVENS FOOT & ANKLE LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "WARDLE",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "425-775-6996",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "POOOOOO411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7094816",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE RIDER",
            "identifier": "ST5742",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L AND I",
            "identifier": "0124633",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "CH7422",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmonds, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2008; 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.