NPIMap

Organization Active NPI

Foot & Ankle Clinics of Southern Iowa, PC

  • Podiatrist
  • Ottumwa, IA
National Provider Identifier
1154549640
Registry record updated Jan 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
00453 Issued in IA
Legal business name
FOOT & ANKLE CLINICS OF SOUTHERN IOWA, PC
Practice address
301 W 2ND St Ste 2
Ottumwa, IA 52501-2576
Phone
(641) 684-8448
Fax
(855) 691-4101
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2026

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

Authorized official

Name
David L. Wanner, DPMNPI 1558566208
Title
Owner
Phone
(641) 684-8448

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 00453 IA Primary

Addresses

Primary practice location

301 W 2ND St Ste 2
Ottumwa, IA 52501-2576

Mailing address

301 W 2ND St Ste 2
Ottumwa, IA 52501-2576
Phone (641) 684-8448

Other identifiers 1

IdentifierTypeStateIssuer
0249003MedicaidIA

Other names 1

  • Ottumwa Foot & 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
O20040317000601 IA Part B Supplier - Clinic/Group Practice 6305736026 Receives reassigned benefits from 8 practitioners
Practice locations: Ottumwa, IA
O20100930091136 IA DME Supplier - Physician - Podiatry 6305736026 Practice locations: Ottumwa, IA

National Provider Directory

National Provider Directory

Locations

381 Highway 34 W
Ste 1
Albia, IA 52531
Phone (641) 452-9355

301 W 2nd St
Ste 2
Ottumwa, IA 52501
Phone (641) 684-8448

1005 Pennsylvania Ave
Ste 202
Ottumwa, IA 52501
Phone (641) 684-8448

925 Church St
Ottumwa, IA 52501
Phone (641) 814-5437

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767916800000",
    "number": "1154549640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 W 2ND ST STE 2",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012576",
            "telephone_number": "641-684-8448",
            "fax_number": "855-691-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 W 2ND ST STE 2",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012576",
            "telephone_number": "641-684-8448",
            "fax_number": "855-691-4101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT & ANKLE CLINICS OF SOUTHERN IOWA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2026-01-09",
        "certification_date": "2026-01-09",
        "status": "A",
        "authorized_official_last_name": "WANNER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "641-684-8448",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IA",
            "license": "00453",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0249003",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ottumwa Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ottumwa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; 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.