Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ellsworth Foot and Ankle Clinic

Organization Podiatrist · NPI 1639769672

Ellsworth Foot and Ankle Clinic is a Podiatrist in Atlanta, Georgia. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
6
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Practice location Address checks out

505 Fairburn Rd SW Ste 100
Atlanta, GA 30331-2012
Phone: (404) 618-6077
Fax: (801) 253-6888
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatric Clinic/Center (primary) Taxonomy 261QP1100X
Podiatrist Taxonomy 213E00000X
Primary Podiatric Medicine Podiatrist Taxonomy 213EP1101X
Radiology Podiatrist Taxonomy 213ER0200X
Sports Medicine Podiatrist Taxonomy 213ES0000X
Foot Surgery Podiatrist Taxonomy 213ES0131X

Record details

NPI number1639769672
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationEllsworth Foot and Ankle Clinic
Authorized official Ryan Ellsworth — Ceo · (801) 253-6886
Other names Summit Foot And Ankle
NPI enumeratedJanuary 23, 2021
Last updated in NPPESSeptember 25, 2024
Certification dateSeptember 25, 2024
Mailing address9980 S 300 W Ste 300, Sandy, UT 84070-3654

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