NPIMap

Organization Active NPI

Foot & Ankle Specialists of West Michigan P L L C

  • Foot & Ankle Surgery Podiatrist
  • Newaygo, MI
National Provider Identifier
1114755634
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FOOT & ANKLE SPECIALISTS OF WEST MICHIGAN P L L C
Practice address
501 W Washington St
Newaygo, MI 49337-8036
Phone
(231) 652-5955
NPI assigned
Jul 25, 2024
Organization subpart
Yes
Parent organization
FOOT & ANKLE SPECIALISTS OF WEST MICHIGAN P L L CAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Authorized official

Name
Lowell Scott Weil, DPM
Title
Executive Chairman
Phone
(847) 390-7666

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X
Foot & Ankle Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0103X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

501 W Washington St
Newaygo, MI 49337-8036

Mailing address

2144 E Paris Ave SE Ste 100
Grand Rapids, MI 49546-6117
Phone (616) 281-0666

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250304002382 MI DME Supplier - Physician - Podiatry 2769475441 Practice locations: Newaygo, MI

Other NPIs with the same Medicare PAC ID 9

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

National Provider Directory

National Provider Directory
Tax ID family
Foot and Ankle Spec of10 organizations share this tax ID, including this one
Part of
Foot and Ankle Spec of

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2144 East Paris Ave SE
Ste 100
Grand Rapids, MI 49546
Phone (616) 281-0666

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1721865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1114755634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2144 E PARIS AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466117",
            "telephone_number": "616-281-0666",
            "fax_number": "224-220-9345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 W WASHINGTON ST",
            "city": "NEWAYGO",
            "state": "MI",
            "postal_code": "493378036",
            "telephone_number": "231-652-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE SPECIALISTS OF WEST MICHIGAN P L L C",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FOOT & ANKLE SPECIALISTS OF WEST MICHIGAN P L L C",
        "enumeration_date": "2024-07-25",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "WEIL",
        "authorized_official_first_name": "LOWELL",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "EXECUTIVE CHAIRMAN",
        "authorized_official_telephone_number": "847-390-7666",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newaygo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; 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.