NPIMap

Organization Active NPI

Nebraska Lower Extremity Surgery Group, LLC

Doing business as Foot and Ankle Specialists

  • Foot & Ankle Surgery Podiatrist
  • Omaha, NE
National Provider Identifier
1104242437
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
289 Issued in NE
Legal business name
NEBRASKA LOWER EXTREMITY SURGERY GROUP, LLC
Doing business as
Foot and Ankle Specialists
Practice address
18010 R PLZ
Suite 106
Omaha, NE 68135-1923
Phone
(402) 991-8999
Fax
(402) 331-6537
NPI assigned
Mar 11, 2014
Last updated
Aug 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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

Authorized official

Name
Chad Summy, DPM
Title
Owner
Phone
(402) 991-8999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 289 NE Primary

Addresses

Primary practice location

18010 R PLZ
Suite 106
Omaha, NE 68135-1923

Mailing address

2705 Samson Way
Bellevue, NE 68123-4307
Phone (402) 991-8999

Other names 1

  • Foot and Ankle Specialists Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111208000645 NE DME Supplier - Physician - PodiatryDME Supplier - Independently-Practicing Physical Therapist 0547448953 1 other NPI on this enrollment
Practice locations: Omaha, NE

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Nebraska Lower Surgery LLC2 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

2705 Samson Way
Bellevue, NE 68123
Phone (402) 331-6387

NPI Registry JSON

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

{
    "created_epoch": "1394496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598572800000",
    "number": "1104242437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 SAMSON WAY",
            "city": "BELLEVUE",
            "state": "NE",
            "postal_code": "681234307",
            "telephone_number": "402-991-8999",
            "fax_number": "402-331-6537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18010 R PLZ",
            "address_2": "SUITE 106",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681351923",
            "telephone_number": "402-991-8999",
            "fax_number": "402-331-6537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEBRASKA LOWER EXTREMITY SURGERY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-11",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A",
        "authorized_official_last_name": "SUMMY",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "402-991-8999",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NE",
            "license": "289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foot and Ankle Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Foot and Ankle Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.