Active NPI
Foot and Ankle Clinic, PC
- Foot & Ankle Surgery Podiatrist
- Viborg, SD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 00505
- Legal business name
- FOOT AND ANKLE CLINIC, PC
- Practice address
- 315 N Washington St
Viborg, SD 57070-2002 - Phone
- (605) 326-5161
- Fax
- (605) 326-5734
- NPI assigned
- Jan 28, 2011
- Last updated
- Jun 14, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kham Vay Ung, DPM
- Title
- President/Owner
- Phone
- (712) 255-0502
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 00505 | IA | Primary |
Addresses
Primary practice location
315 N Washington St
Viborg, SD 57070-2002
Mailing address
1502 Pierce St
Sioux City, IA 51105-1246
Phone (712) 255-0502
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6800454 | Medicaid | SD | |
| 123 | Other | SD | LICENSE NUMBER |
National Provider Directory
National Provider DirectoryLocations
1502 Pierce St
Sioux City, IA 51105
Phone (712) 255-0502
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Foot & Ankle Surgery Podiatrist
- Sioux City, IA
- NPI 1205937554
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1296172800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1465862400000",
"number": "1033415799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1502 PIERCE ST",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "511051246",
"telephone_number": "712-255-0502",
"fax_number": "712-258-9977"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "315 N WASHINGTON ST",
"city": "VIBORG",
"state": "SD",
"postal_code": "570702002",
"telephone_number": "605-326-5161",
"fax_number": "605-326-5734"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOOT AND ANKLE CLINIC, PC",
"organizational_subpart": "NO",
"enumeration_date": "2011-01-28",
"last_updated": "2016-06-14",
"status": "A",
"authorized_official_last_name": "UNG",
"authorized_official_first_name": "KHAM",
"authorized_official_middle_name": "VAY",
"authorized_official_title_or_position": "PRESIDENT/OWNER",
"authorized_official_telephone_number": "712-255-0502",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "IA",
"license": "00505",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6800454",
"state": "SD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "123",
"state": "SD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Viborg, SD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.