NPIMap

Organization Active NPI

Kentuckiana Foot & Ankle PLLC

  • Durable Medical Equipment & Medical Supplies
  • Bardstown, KY
National Provider Identifier
1154808798
Registry record updated Dec 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
KENTUCKIANA FOOT & ANKLE PLLC
Practice address
900 Chambers Blvd
Bardstown, KY 40004-2527
Phone
(502) 331-6307
Fax
(502) 331-6309
NPI assigned
Jul 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2023

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

Authorized official

Name
Syed A Khader, DPMNPI 1841272721
Title
Owner Physician
Phone
(502) 968-2233

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
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

900 Chambers Blvd
Bardstown, KY 40004-2527

Mailing address

6801 Dixie Hwy
Ste 134
Louisville, KY 40258-3952
Phone (502) 850-2447

Other names 1

  • Tipton & Unroe Foot and Ankle Care inc. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181030000675 KY DME Supplier - Physician - Podiatry 4880752443 Practice locations: Bardstown, KY

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Kentuckiana Foot and Ankle PLLC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

Locations

935 Chambers Blvd
Unit D
Bardstown, KY 40004
Phone (502) 348-6011

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": "1532563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703203200000",
    "number": "1154808798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 DIXIE HWY",
            "address_2": "STE 134",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402583952",
            "telephone_number": "502-850-2447",
            "fax_number": "502-449-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CHAMBERS BLVD",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400042527",
            "telephone_number": "502-331-6307",
            "fax_number": "502-331-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENTUCKIANA FOOT & ANKLE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-26",
        "last_updated": "2023-12-22",
        "certification_date": "2021-10-14",
        "status": "A",
        "authorized_official_last_name": "KHADER",
        "authorized_official_first_name": "SYED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "502-968-2233",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tipton & Unroe Foot and Ankle Care inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bardstown, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2023; 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.