Organization Active NPI

Karen M. Ackerman, D.P.M., P.a.

  • Podiatrist
  • Dodge City, KS
National Provider Identifier
1093984197
Registry record updated Jul 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
12-00286 Issued in KS
Legal business name
KAREN M. ACKERMAN, D.P.M., P.A.
Practice address
2300 N 14TH Ave Ste 100a
Dodge City, KS 67801-2367
Phone
(620) 225-7829
Fax
(620) 225-4827
NPI assigned
Feb 22, 2008
Last updated
Jul 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2009

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

Authorized official

Name
Dr. Karen M Ackerman, D.P.M.NPI 1669495776
Title
Owner/Podiatrist
Phone
(620) 225-7829

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 12-00286 KS Primary

Addresses

Primary practice location

2300 N 14TH Ave Ste 100a
Dodge City, KS 67801-2367

Mailing address

2300 N 14TH Ave Ste 100a
Dodge City, KS 67801-2367
Phone (620) 225-7829

Other identifiers 2

IdentifierTypeStateIssuer
480026013OtherRAILROAD MEDICARE
114024OtherKSBLUECROSS BLUESHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080520000861 KS Part B Supplier - Clinic/Group Practice 9335218072 Receives reassigned benefits from 1 practitioner
Practice locations: Dodge City, KS

National Provider Directory

National Provider Directory

Locations

2300 N 14th Ave
Ste 100A
Dodge City, KS 67801
Phone (316) 225-7829

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": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247702400000",
    "number": "1093984197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N 14TH AVE STE 100A",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678012367",
            "telephone_number": "620-225-7829",
            "fax_number": "620-225-4827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N 14TH AVE STE 100A",
            "city": "DODGE CITY",
            "state": "KS",
            "postal_code": "678012367",
            "telephone_number": "620-225-7829",
            "fax_number": "620-225-4827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAREN M. ACKERMAN, D.P.M., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2009-07-16",
        "status": "A",
        "authorized_official_last_name": "ACKERMAN",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PODIATRIST",
        "authorized_official_telephone_number": "620-225-7829",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "KS",
            "license": "12-00286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480026013",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "114024",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dodge City, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; 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.