NPIMap

Organization Active NPI

Midwest Foot and Ankle Specialists, LLC

  • Foot & Ankle Surgery Podiatrist
  • Blaine, MN
National Provider Identifier
1063704807
Registry record updated May 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
631 Issued in MN
Legal business name
MIDWEST FOOT AND ANKLE SPECIALISTS, LLC
Practice address
11901 Central Ave NE
Blaine, MN 55434-3911
Phone
(612) 788-8778
Fax
(612) 788-3408
NPI assigned
May 12, 2011
Last updated
May 12, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2011

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

Authorized official

Name
Bryan L Mohr, DPMNPI 1043215528
Title
Owner
Phone
(612) 788-7274

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)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 631 MN Primary

Addresses

Primary practice location

11901 Central Ave NE
Blaine, MN 55434-3911

Mailing address

11901 Central Ave NE
Blaine, MN 55434-3911
Phone (612) 788-8778

National Provider Directory

National Provider Directory
Tax ID family
Midwest Foot Ankle Specialists LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

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": "1305158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305158400000",
    "number": "1063704807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11901 CENTRAL AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343911",
            "telephone_number": "612-788-8778",
            "fax_number": "612-788-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11901 CENTRAL AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554343911",
            "telephone_number": "612-788-8778",
            "fax_number": "612-788-3408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST FOOT AND ANKLE SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-12",
        "last_updated": "2011-05-12",
        "status": "A",
        "authorized_official_last_name": "MOHR",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-788-7274",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MN",
            "license": "631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; 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.