SPECTRUM FALLS FOOT & ANKLE SPECIALISTS, PC (NPI# 1053447243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053447243 |
| Entity Type | Organization |
| Organization Name | SPECTRUM FALLS FOOT & ANKLE SPECIALISTS, PC |
| Practice Address |
2730 S Val Vista Dr Suite 158 Gilbert AZ 85296-6675 |
| Practice Telephone | 4808897055 |
| Practice Fax Number | 4808897054 |
| Mailing Telephone | 4808897055 |
| Mailing Fax Number | 4808897054 |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2007-12-13 |
| Authorized Official Name | DR. CLARK J FULLMER II (PHYSICIAN) |
| Authorized Official Telephone | 4808897055 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
0484 | AZ | Podiatric Medicine & Surgery Service Providers |
| Street Address |
2730 S VAL VISTA DR SUITE 158 |
| City | GILBERT |
| State | AZ |
| Zip Code | 85296-6675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407848369 | M. Kathleen Mcbride | Social Worker | 2730 S Val Vista Dr, Suite 135, Gilbert, AZ 85295-1675 | 2005-08-17 |
| 1134698566 | Titilayo Grant | Nurse Practitioner | 2730 S Val Vista Dr, Gilbert, AZ 85295-1675 | 2018-11-14 |
| 1427584473 | Vincent Liou | Physician Assistant | 2730 S Val Vista Dr, #161, Gilbert, AZ 85295-1675 | 2017-05-11 |
| 1558897439 | Az Choice Foot and Ankle | Podiatrist | 2730 S Val Vista Dr, Suite 136, Gilbert, AZ 85295-1675 | 2017-05-11 |
| 1740716489 | Keith Bradshaw | Social Worker | 2730 S Val Vista Dr, Gilbert, AZ 85295-1675 | 2017-05-01 |
| 1477004935 | Pediatric Adult Endocrine Gilbert | Pediatrics | 2730 S Val Vista Dr, Bldg 10, Suite 161, Gilbert, AZ 85295 | 2016-10-20 |
| 1124481031 | Catherine Surovy | Counselor | 2730 S Val Vista Dr, #137, Gilbert, AZ 85295-1675 | 2016-03-30 |
| 1619333549 | Kara Sell | Nurse Practitioner | 2730 S Val Vista Dr, Suit 146, Gilbert, AZ 85295-1675 | 2016-01-07 |
| 1952766149 | Mark Waldrop II | Counselor | 2730 S Val Vista Dr, Suites 146 & 137, Gilbert, AZ 85295-1675 | 2015-12-15 |
| 1003293606 | Mark Wesbrock | Registered Nurse | 2730 S Val Vista Dr, Suite 137, Gilbert, AZ 85295-1675 | 2015-05-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124625793 | Gilbert Crossroads Kids' Dentists and Orthodontics, LLP | Dentist | 835 S. Gilbert Rd, Suite 104, Gilbert, AZ 85296 | 2020-10-06 |
| 1306455969 | Calm Care Living | Community/Behavioral Health | 1525 S Higley Rd, #104-6769, Gilbert, AZ 85296 | 2020-07-29 |
| 1366080970 | Hannah Golladay | Behavior Technician | 1166 S Gilbert Road, Suite 106, Mesa, AZ 85296 | 2019-12-13 |
| 1194284729 | Kege Health, LLC | Nurse Practitioner | 1206 E Warner Rd Ste 101f, Gilbert, AZ 85296 | 2019-03-13 |
| 1841757762 | Windhorse Counseling | Counselor | 1166 E Warner Road, Suite 203, Gilbert, AZ 85296 | 2019-02-27 |
| 1417424284 | Ashton N Wright | Behavior Technician | 1166 E Gilbert Rd, #106, Gilbert, AZ 85296 | 2018-10-30 |
| 1346717246 | Robison Orthodontics LLC | Dentist | 1355 S Higley Rd # 105, Gilbert, AZ 85296 | 2018-10-29 |
| 1518441831 | Kara Lyn Holyoak | Physician Assistant | 1359 S. Porter St., Gilbert, AZ 85296 | 2018-09-21 |
| 1225519119 | Jennifer Anne Goodman | Specialist/Technologist | 70 S Val Vista Dr A3, Gilbert, AZ 85296 | 2018-08-28 |
| 1437642329 | Greta Shumway | Counselor | 690 E. Warner Road, #115, Gilbert, AZ 85296 | 2018-06-14 |
| Find all providers in zip 85296 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629535273 | Saguaro Foot and Ankle | Podiatrist | 2128 E Maplewood St, Gilbert, AZ 85297-1140 | 2019-03-01 |
| 1043694235 | Brent Weintrub | Podiatrist | 633 E Ray Rd Ste 128, Gilbert, AZ 85296 | 2015-07-17 |
| 1760770556 | Nicole L Adams | Podiatrist | 4915 E Baseline Rd Ste 121, Gilbert, AZ 85234-2969 | 2011-07-14 |
| 1477844959 | Gregory Rowe | Podiatrist | 3011 S Lindsay Rd Ste 113, Gilbert, AZ 85295-4334 | 2011-05-02 |
| 1457675126 | Vu Thai Nguyen | Podiatrist | 2915 E Baseline Rd Ste 103, Gilbert, AZ 85234-2427 | 2010-03-24 |
| 1356676449 | Frank Maben Dpm LLC | Podiatrist | 3120 E Kingbird Ct, Gilbert, AZ 85297-8163 | 2009-10-07 |
| 1700014552 | Shaun Simmons | Podiatrist | 1355 S Higley Rd Ste 112, Gilbert, AZ 85296-4799 | 2009-06-30 |
| 1043446131 | Robert Christopher Andersen | Podiatrist | 3336 E Chandler Heights Rd Ste 121, Gilbert, AZ 85298-4263 | 2009-06-03 |
| 1104083369 | Modern Foot & Ankle Centers, Pllc | Podiatrist | 2680 S Val Vista Dr Bldg 14, Suite 177, Gilbert, AZ 85295 | 2008-05-16 |
| 1295906212 | Darick Hathaway Freestone | Podiatrist | 2680 S. Val Vista Dr. Suite 177, Bldg 14, Gilbert, AZ 85295-4234 | 2008-03-18 |
| Find all providers in GILBERT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.