NPIMap

Organization Active NPI

Maplewood Podiatry, LLC

  • Podiatrist
  • Maplewood, MN
National Provider Identifier
1023069259
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
MAPLEWOOD PODIATRY, LLC
Practice address
2520 White Bear Ave N
Suite a
Maplewood, MN 55109-5136
Phone
(651) 770-3891
Fax
(651) 748-3117
NPI assigned
May 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Vince Simone, DPM
Title
Owner
Phone
(651) 770-3891

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

2520 White Bear Ave N
Suite a
Maplewood, MN 55109-5136

Mailing address

2520 White Bear Ave N
Suite a
Maplewood, MN 55109-5136
Phone (651) 770-3891

Other identifiers 1

IdentifierTypeStateIssuer
156603200MedicaidMN

Other names 1

  • Midwest Foot & Ankle Specialists Former legal business name

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

6120 Brooklyn Blvd
Ste 202
Brooklyn Ctr, MN 55429
Phone (763) 535-9033

12940 Harriet Ave S
Ste 210
Burnsville, MN 55337
Phone (952) 890-4060

5201 Eden Ave
Ste 50
Minneapolis, MN 55436
Phone (763) 545-7545

4001 Stinson Blvd NE
Ste 232
Minneapolis, MN 55421
Phone (612) 788-7274

318 Bush St
Red Wing, MN 55066
Phone (651) 388-1553

98 W 66th St
Ste 204
Richfield, MN 55423
Phone (612) 788-0170

280 Smith Ave N
Ste 435
Saint Paul, MN 55102
Phone (651) 224-9204

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1023069259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 WHITE BEAR AVE N",
            "address_2": "SUITE A",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095136",
            "telephone_number": "651-770-3891",
            "fax_number": "651-748-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 WHITE BEAR AVE N",
            "address_2": "SUITE A",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551095136",
            "telephone_number": "651-770-3891",
            "fax_number": "651-748-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLEWOOD PODIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-12",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "SIMONE",
        "authorized_official_first_name": "VINCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-770-3891",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "156603200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Foot & Ankle Specialists",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.