Organization Active NPI

Foot and Ankle Clinic LLP

  • Foot & Ankle Surgery Podiatrist
  • Menomonie, WI
National Provider Identifier
1144308321
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
FOOT AND ANKLE CLINIC LLP
Practice address
201 Cedar Falls Rd
Menomonie, WI 54751-1270
Phone
(715) 235-4274
Fax
(715) 235-9644
NPI assigned
Nov 2, 2006
Last updated
Jan 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Authorized official

Name
Vicki Mack
Title
Manager
Phone
(715) 235-4274

Specialties & licenses 1

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

Addresses

Primary practice location

201 Cedar Falls Rd
Menomonie, WI 54751-1270

Mailing address

PO Box 392
Menomonie, WI 54751-0392
Phone (715) 235-4274

Other identifiers 1

IdentifierTypeStateIssuer
43263800MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090630000563 WI Part B Supplier - Clinic/Group Practice 3971654021 Receives reassigned benefits from 5 practitioners
Practice locations: Rice Lake, WI; Stanley, WI; Shell Lake, WI; Menomonie, WI; Eau Claire, WI; Durand, WI; Cumberland, WI; Chippewa Falls, WI…
O20100930008385 WI DME Supplier - Physician - Podiatry 3971654021 Practice locations: Menomonie, WI

National Provider Directory

National Provider Directory

Locations

719 W Hamilton Ave
Ste A
Eau Claire, WI 54701
Phone (715) 235-4274

201 Cedar Falls Rd
Menomonie, WI 54751
Phone (715) 235-4274

1701 W Knapp St
Rice Lake, WI 54868
Phone (800) 359-4421

2021 Cenex Dr
Unit K
Rice Lake, WI 54868
Phone (715) 434-3124

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/gOP4994uTxKCP3l4vJ7Jqo6k1NZgHGsz/

Practitioners & affiliated clinicians

Practitioners 5

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": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1144308321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547510392",
            "telephone_number": "715-235-4274",
            "fax_number": "715-235-9644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 CEDAR FALLS RD",
            "city": "MENOMONIE",
            "state": "WI",
            "postal_code": "547511270",
            "telephone_number": "715-235-4274",
            "fax_number": "715-235-9644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE CLINIC LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "MACK",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "715-235-4274"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43263800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Menomonie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.