Organization Active NPI

Family Foot Healthcare LLC

  • Podiatrist
  • Cameron, MO
National Provider Identifier
1104832872
Registry record updated Nov 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
795 Issued in MO
Legal business name
FAMILY FOOT HEALTHCARE LLC
Practice address
609 East Platte Clay Way
Suite a
Cameron, MO 64429
Phone
(816) 632-5228
Fax
(816) 632-5229
NPI assigned
Aug 1, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Nancy Kay Gasparovic, DPM
Title
Owner
Phone
(816) 632-5228

National Provider Directory

National Provider Directory

Locations

610 Lana Dr
Ste B
Cameron, MO 64429
Phone (816) 632-5228

609 E Platte Clay Way
Ste A
Cameron, MO 64429
Phone (816) 632-5228

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X 795 MO Primary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X 12000295 KS

Addresses

NPPES NPI Registry

Primary practice location

609 East Platte Clay Way
Suite a
Cameron, MO 64429

Mailing address

609 East Platte Clay Way
Suite a
Cameron, MO 64429
Phone (816) 632-5228

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
366006500MedicaidMO

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 19, 2009.

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258588800000",
    "number": "1104832872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 EAST PLATTE CLAY WAY",
            "address_2": "SUITE A",
            "city": "CAMERON",
            "state": "MO",
            "postal_code": "64429",
            "telephone_number": "816-632-5228",
            "fax_number": "816-632-5229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 EAST PLATTE CLAY WAY",
            "address_2": "SUITE A",
            "city": "CAMERON",
            "state": "MO",
            "postal_code": "64429",
            "telephone_number": "816-632-5228",
            "fax_number": "816-632-5229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY FOOT HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2009-11-19",
        "status": "A",
        "authorized_official_last_name": "GASPAROVIC",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-632-5228",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "MO",
            "license": "795",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "KS",
            "license": "12000295",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "366006500",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cameron, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2009; 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.