Organization Active NPI

Central Iowa Podiatry Inc

Doing business as Newton Foot and Ankle Clinic

  • Podiatrist
  • Newton, IA
National Provider Identifier
1114108289
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
00607 Issued in IA
Legal business name
CENTRAL IOWA PODIATRY INC
Doing business as
Newton Foot and Ankle Clinic
Practice address
204 N 2ND Ave W
Newton, IA 50208-3032
Phone
(641) 792-6446
Fax
(641) 792-3556
NPI assigned
Nov 17, 2007
Last updated
Oct 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Authorized official

Name
Sean McMurray, DPMNPI 1548434400
Title
President
Phone
(641) 792-6446

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 00607 IA Primary

Addresses

Primary practice location

204 N 2ND Ave W
Newton, IA 50208-3032

Mailing address

204 N 2ND Ave W
Newton, IA 50208-3032
Phone (641) 792-6446

Other identifiers 4

IdentifierTypeStateIssuer
1114108289OtherIAWELLMARK BC/BS
42-1440625-01OtherIAUNITED HEALTHCARE
480025449OtherIARR MEDICARE
1114108289MedicaidIA

Other names 1

  • NEWTON FOOT AND ANKLE CLINIC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20130829000869 IA DME Supplier - Physician - Podiatry 4082857693 Practice locations: Newton, IA
O20130909000309 IA Part B Supplier - Clinic/Group Practice 4082857693 Receives reassigned benefits from 1 practitioner
Practice locations: Marshalltown, IA; Newton, IA; Pella, IA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1195257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1114108289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 N 2ND AVE W",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502083032",
            "telephone_number": "641-792-6446",
            "fax_number": "641-792-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 N 2ND AVE W",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502083032",
            "telephone_number": "641-792-6446",
            "fax_number": "641-792-3556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL IOWA PODIATRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-17",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "MCMURRAY",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "641-792-6446",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IA",
            "license": "00607",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BC/BS",
            "identifier": "1114108289",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "42-1440625-01",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "480025449",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114108289",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NEWTON FOOT AND ANKLE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NEWTON FOOT AND ANKLE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.