NPI 1639769672 · live from the CMS NPI Registry
Ellsworth Foot And Ankle Clinic
Clinic/Center, Podiatric in Atlanta, GA. National Provider Identifier 1639769672, active.
NPI record
| NPI | 1639769672 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Podiatric 261QP1100X |
| Practice location | 505 Fairburn Rd Sw Ste 100, Atlanta, GA 30331 |
| Practice phone | 404-618-6077 |
| Mailing address | 9980 S 300 W Ste 300, Sandy, UT 84070 |
| Enumerated | January 23, 2021 |
| Last updated | September 25, 2024 |
| Authorized official | Ryan Ellsworth, Ceo |
| Other names | Summit Foot And Ankle |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Podiatrist | 213E00000X | — |
| Podiatrist, Primary Podiatric Medicine | 213EP1101X | — |
| Podiatrist, Radiology | 213ER0200X | — |
| Podiatrist, Sports Medicine | 213ES0000X | — |
| 213ES0131X | — | |
| Clinic/Center, Podiatric primary | 261QP1100X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.