MEDICARE: ELLSWORTH FOOT AND ANKLE CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1699400762
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELLSWORTH FOOT AND ANKLE CLINIC

Provider Business Mailing Address
First Line	:	9980 S 300 W STE 310
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84070-3654
Country	:	US
Telephone Number	:	801-253-6886
Fax Number	:	385-900-5928

Provider Business Practice Location Address
First Line	:	3715 W 4100 S STE 150
Second Line	:
City	:	WEST VALLEY
State	:	UT
Zip	:	84120-5552
Country	:	US
Telephone Number	:	801-253-6886
Fax Number	:	801-253-6888

Authorized Official
Title or Position	:	CEO
Name	:	RYAN ELLSWORTH
Credential	:
Telephone Number	:	801-253-6886

Provider Enumeration Date	:	07/21/2022
Last Update Date	:	07/21/2022

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1598763294 — UTAH IMAGING CENTERS LLC
Practice Location Address:

3715 W 4100 S , STE 150
WEST VALLEY CITY, UT
84120-5552

Practice Phone: 801-924-0029
Practice Fax:

1962152884 — WEST VALLEY ORAL SURGERY PC
Practice Location Address:

3715 W 4100 S STE 150
WEST VALLEY, UT
84120-5552

Practice Phone: 801-285-9693
Practice Fax:

1225073588 — VALLEY ASSOCIATED UROLOGY MEDICARE GROUP INC
Practice Location Address:

200 COTTAGE AVE , STE 101
MANTECA, CA
95336-4935

Practice Phone: 209-239-2197
Practice Fax: 209-239-7672

1356809594 — ISELEN BUSINESS ENTERPRISE, INC
Practice Location Address:

3137 CASTRO VALLEY BLVD STE 201
CASTRO VALLEY, CA
94546-5552

Practice Phone: 510-690-9612
Practice Fax: 510-690-9652

1366537672 — DR. ANDREW LEE HECK PSY.D.
Practice Location Address:

1 PARK WEST CIR STE 102
MIDLOTHIAN, VA
23114-5552

Practice Phone: 804-993-4304
Practice Fax: 855-998-4376

Directions to “ELLSWORTH FOOT AND ANKLE CLINIC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.