MOUNTAIN CREST FOOT AND ANKLE PA
NPI 1932191996
Podiatrist in Idaho Falls, ID

Q: What is Mountain Crest Foot And Ankle PA's NPI number?

The NPI number for Mountain Crest Foot And Ankle PA is 1932191996. It was assigned to this organization in the NPPES registry on August 16, 2005.

Q: What is Mountain Crest Foot And Ankle PA's specialty?

The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.

Active since August 16, 2005

3652 WASHINGTON PKWY, IDAHO FALLS, ID 83404(208) 528-8700(208) 528-2802 Get Directions Write a Review

NPPES record last updated: December 6, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Mountain Crest Foot And Ankle Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOUNTAIN CREST FOOT AND ANKLE PA (NPI 1932191996) is a healthcare organization registered as a podiatrist in Idaho Falls, Idaho and active in the NPI registry since August 2005. The organization lists Timothy Roger Black, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1932191996

Entity TypeOrganization

Primary Taxonomy213E00000X

Legal Business NameMOUNTAIN CREST FOOT AND ANKLE PA

Location Address3652 WASHINGTON PKWYIdaho Falls, ID 83404-7573

Mailing Address3652 Washington PkwyIdaho Falls, ID 83404-7573 · (208) 528-8700 · Fax (208) 528-2802

Phone(208) 528-8700

Fax(208) 528-2802

Organization SubpartNo

Authorized OfficialTimothy Roger BlackOwner/physician · (208) 528-8700

Enumeration DateAugust 16, 2005

Last NPPES UpdateDecember 6, 2010

✔ NPI 1932191996 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPodiatristPodiatric Medicine & Surgery Service Providers

Taxonomy Code213E00000X

License✔ Licensed in ID · P-169

Definition

A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

3652 WASHINGTON PKWY, Idaho Falls, ID 83404

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Other Identifiers 4

Medicaid806462800ID

Medicare NSC4590880001ID

Medicare UPINU92156

Medicare ID-Type Unspecified1350919ID

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include University of Utah Health Plans.Insurance ›

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ORANGE, LLC

Nurse Practitioner (Family)