Family Foot Clinic – Podiatrist in Macon, MO

Key facts

NPI: 1104015189
Entity type: Organization (NPI type 2)
Primary specialty: Podiatrist 213E00000X
Legal business name: FAMILY FOOT CLINIC
Practice address: 1501 N Missouri St
Macon, MO 63552-1969
Phone: (660) 385-4464
Fax: (660) 385-1449
NPI assigned: Oct 16, 2007
Organization subpart: No

Authorized official

Name: Kathy Beauchamp
Title: Office Manager
Phone: (660) 385-4464

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Keith Alan Beauchamp, D.P.M. Podiatrist · Macon, MO · NPI 1437150117

NPD (past) PODIATRIST
Jonathon Lee Fallis, DPM Podiatrist · Moberly, MO · NPI 1659391084

NPD (past) PODIATRIST

National Provider Directory

Locations

1501 N Missouri St
Macon, MO 63552
Phone (660) 385-4464

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Podiatrist Group: 193400000X SINGLE SPECIALTY GROUP	213E00000X			Yes

Addresses

Primary practice location

1501 N Missouri St
Macon, MO 63552-1969

Mailing address

1501 N Missouri St
Macon, MO 63552-1969
Phone (660) 385-4464

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 27, 2011.

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311724800000",
    "number": "1104015189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 N MISSOURI ST",
            "city": "MACON",
            "state": "MO",
            "postal_code": "635521969",
            "telephone_number": "660-385-4464",
            "fax_number": "660-385-1449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 N MISSOURI ST",
            "city": "MACON",
            "state": "MO",
            "postal_code": "635521969",
            "telephone_number": "660-385-4464",
            "fax_number": "660-385-1449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FOOT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2011-07-27",
        "status": "A",
        "authorized_official_last_name": "BEAUCHAMP",
        "authorized_official_first_name": "KATHY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "660-385-4464"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, MO

All providers in Macon, MO · Podiatrist in Missouri

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.