Clint Vanlandingham

Primary specialty

PodiatristTaxonomy code 213E00000X

License

2004001321 Issued in MO

Legal business name

CLINT VANLANDINGHAM

Doing business as

Coppertop Foot and Ankle Clinic

Practice address

2600 Kanell Blvd
Poplar Bluff, MO 63901-3001

Phone

(573) 785-4546

NPI assigned

Apr 7, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Clint Vanlandingham, DPMNPI 1508838566

Title

Owner

Phone

(573) 785-4546

Specialties & licenses 2

Addresses

Other names 1

• Coppertop Foot and Ankle Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 3

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

• Clint L Vanlandingham, DPM

  • Podiatrist
  • Poplar Bluff, MO
  • NPI 1508838566
  NPD Authorized official
• Richard Armen Amundsen, DPM

  • Podiatrist
  • Poplar Bluff, MO
  • NPI 1366001190
  NPD (past)
• Jeffrey David Baller, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Poplar Bluff, MO
  • NPI 1710981519
  NPD (past)

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589500800000",
    "number": "1144283524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013001",
            "telephone_number": "573-785-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 KANELL BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013001",
            "telephone_number": "573-785-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINT VANLANDINGHAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-07",
        "last_updated": "2020-05-15",
        "certification_date": "2020-05-15",
        "status": "A",
        "authorized_official_last_name": "VANLANDINGHAM",
        "authorized_official_first_name": "CLINT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-785-4546",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MO",
            "license": "2004001321",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coppertop Foot and Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coppertop Foot and Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cleous Chiropractic LLC
• Katelyn Brooke Cleous, PMHNP
• Ryan Cleous, DC
• Katie Leanne Cletcher, NCC
• Kimberly Sue Cline, PMHNP
• Brittany Deanne Cobb
• Gregory Coble II
• Sheila Marie Cochran
• Marissa Kimberly Cohen, OTR/L
• Sierra N Coke

• Podiatrist in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Podiatrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.