Woodlake Podiatry, LLC

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

2015014632 Issued in MO

Legal business name

WOODLAKE PODIATRY, LLC

Practice address

222 S Woods Mill Rd Ste 440N
Chesterfield, MO 63017-3625

Phone

(314) 434-7430

Fax

(314) 434-8768

NPI assigned

Aug 18, 2016

Organization subpart

No

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

Authorized official

Name

Sheryl Hanawalt, D.P.M.NPI 1780971846

Title

Podiatrist/Owner

Phone

(314) 434-7430

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

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.

• Sheryl L Hanawalt, DPM

  • Foot & Ankle Surgery Podiatrist
  • Chesterfield, MO
  • NPI 1780971846
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675209600000",
    "number": "1093260176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD # 440N",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173625",
            "telephone_number": "314-434-7430",
            "fax_number": "314-434-8768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD STE 440N",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173625",
            "telephone_number": "314-434-7430",
            "fax_number": "314-434-8768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLAKE PODIATRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-18",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A",
        "authorized_official_last_name": "HANAWALT",
        "authorized_official_first_name": "SHERYL",
        "authorized_official_title_or_position": "PODIATRIST/OWNER",
        "authorized_official_telephone_number": "314-434-7430",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2015014632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luu Thi Wong, OT
• Alexander Fred Wood, PHARM.D.
• John A Wood, MD
• John R Wood, MA
• Woodlake Podiatry
• Woods Mill Medical Associates, LLC
• Woods Mill Orthopedics LTD
• Woods Mill Pediatric and Adolescent Medicine, LLC
• Jody Lynn Woodward, PH.D.
• Wright & Wright, PHD, LLC

• Foot & Ankle Surgery Podiatrist in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Foot & Ankle Surgery Podiatrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; 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.