Organization Active NPI

Sedalia Foot Clinic PC

  • Foot Surgery Podiatrist
  • Sedalia, MO
National Provider Identifier
1174559579
Registry record updated Jun 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot Surgery PodiatristTaxonomy code 213ES0131X
License
000587 Issued in MO
Legal business name
SEDALIA FOOT CLINIC PC
Practice address
519 E 13TH St
Sedalia, MO 65301-5909
Phone
(660) 826-5897
Fax
(660) 826-4691
NPI assigned
Jun 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2015

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

Authorized official

Name
Mrs. Paula A Brown
Title
Office Manager
Phone
(660) 826-5897

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot Surgery PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213ES0131X 000587 MO Primary

Addresses

Primary practice location

519 E 13TH St
Sedalia, MO 65301-5909

Mailing address

519 E 13TH St
Sedalia, MO 65301-5909
Phone (660) 826-5897

Other identifiers 1

IdentifierTypeStateIssuer
366092807MedicaidMO

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1174559579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 E 13TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653015909",
            "telephone_number": "660-826-5897",
            "fax_number": "660-826-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "519 E 13TH ST",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653015909",
            "telephone_number": "660-826-5897",
            "fax_number": "660-826-4691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEDALIA FOOT CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "660-826-5897",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": "MO",
            "license": "000587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "366092807",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedalia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.