Crestwood Foot Clinic, LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

87 Issued in AR

Legal business name

CRESTWOOD FOOT CLINIC, LLC

Practice address

2501 Crestwood Rd
Suite 101
North Little Rock, AR 72116-6864

Phone

(501) 771-4785

Fax

(501) 771-4785

NPI assigned

Apr 29, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Martha A. Jackson, DPM

Title

Owner

Phone

(501) 771-4785

Specialties & licenses 1

Addresses

Tax ID family

Crestwood Foot Clinic LLC2 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.

• Crestwood Foot Clinic LLC

  • Prosthetic/Orthotic Supplier
  • North Little Rock, AR
  • NPI 1538321260
  NPD tax ID

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594684800000",
    "number": "1962677906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CRESTWOOD RD",
            "address_2": "SUITE 101",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721166864",
            "telephone_number": "501-771-4785",
            "fax_number": "501-771-4787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 CRESTWOOD RD",
            "address_2": "SUITE 101",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721166864",
            "telephone_number": "501-771-4785",
            "fax_number": "501-771-4785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTWOOD FOOT CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-771-4785",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "AR",
            "license": "87",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Ann Cranford, APN
• Hannah G Crass
• Deidre Leigh Cravens, P.T.
• Christin Michelle Crawford
• Crestwood Foot Clinic LLC
• Eileen Margaret Croes-Orf, PSYD
• Laura S Crone, LCSW
• Cate Crosland
• Matthew James Crouch, M.D.
• Joe Walter Crow, MD

• Podiatrist in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Podiatrist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.