Organization Active NPI

Desert Sports Foot and Ankle LLC

  • Foot & Ankle Surgery Podiatrist
  • Peoria, AZ
National Provider Identifier
1992090476
Registry record updated Jun 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
DESERT SPORTS FOOT AND ANKLE LLC
Practice address
9431 W Thunderbird Rd Ste 3
Peoria, AZ 85381-4237
Phone
(888) 557-6802
NPI assigned
Jun 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2011

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

Authorized official

Name
James GarberNPI 1942434618
Title
Member
Phone
(888) 557-6802

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0000X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary

Addresses

Primary practice location

9431 W Thunderbird Rd Ste 3
Peoria, AZ 85381-4237

Mailing address

PO Box 5579
Peoria, AZ 85385-5579
Phone (888) 557-6802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120510000156 AZ Part B Supplier - Clinic/Group Practice 7113189051 Receives reassigned benefits from 1 practitioner
Practice locations: Peoria, AZ

National Provider Directory

National Provider Directory

Locations

9431 W Thunderbird Rd
Ste 3
Peoria, AZ 85381
Phone (888) 557-6802

7717 W Deer Valley Rd
Ste 125
Peoria, AZ 85382
Phone (623) 561-6300

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": "1307923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307923200000",
    "number": "1992090476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5579",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853855579",
            "telephone_number": "888-557-6802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9431 W THUNDERBIRD RD STE 3",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814237",
            "telephone_number": "888-557-6802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESERT SPORTS FOOT AND ANKLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-13",
        "last_updated": "2011-06-13",
        "status": "A",
        "authorized_official_last_name": "GARBER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "888-557-6802"
    },
    "taxonomies": [
        {
            "code": "213ES0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; 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.