Organization Active NPI

Wheeling Foot Clinic

Doing business as Wheeling Foot Clinic PLLC

  • Primary Podiatric Medicine Podiatrist
  • Wheeling, WV
National Provider Identifier
1033483763
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X
License
00156 Issued in WV
Legal business name
WHEELING FOOT CLINIC
Doing business as
Wheeling Foot Clinic PLLC
Practice address
1061 Main St
Wheeling, WV 26003-2701
Phone
(304) 233-0500
Fax
(304) 233-0501
NPI assigned
Feb 27, 2012
Last updated
Feb 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Authorized official

Name
Denise Vanscyoc
Title
Office Manager
Phone
(304) 810-4648

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Podiatric Medicine Podiatrist 213EP1101X 00156 WV Primary

Addresses

Primary practice location

1061 Main St
Wheeling, WV 26003-2701

Mailing address

1061 Main St
Wheeling, WV 26003-2701
Phone (304) 843-5066

Other practice location 1

400 3rd St
Glen Dale, WV 26038-1416
Phone (304) 843-5066

Other identifiers 2

IdentifierTypeStateIssuer
3810022864MedicaidWV
1194880047MedicaidWV

Other names 1

  • Wheeling Foot Clinic PLLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130710000455 WV Part B Supplier - Clinic/Group Practice 1153561451 Receives reassigned benefits from 1 practitioner
Practice locations: Glen Dale, WV; Wheeling, WV

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Wheeling Foot Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1061 Main St
Wheeling, WV 26003
Phone (304) 233-0500

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.

NPI Registry JSON

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

{
    "created_epoch": "1330300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1033483763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1061 MAIN ST",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260032701",
            "telephone_number": "304-843-5066",
            "fax_number": "304-233-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 MAIN ST",
            "city": "WHEELING",
            "state": "WV",
            "postal_code": "260032701",
            "telephone_number": "304-233-0500",
            "fax_number": "304-233-0501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 3rd St",
            "address_purpose": "LOCATION",
            "city": "Glen Dale",
            "state": "WV",
            "postal_code": "260381416",
            "country_code": "US",
            "telephone_number": "304-843-5066",
            "fax_number": "304-843-5067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "WHEELING FOOT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-27",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "VANSCYOC",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "304-810-4648"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "WV",
            "license": "00156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810022864",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194880047",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wheeling Foot Clinic PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wheeling, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.