NPIMap

Organization Active NPI

Center for Advanced Foot & Ankle Surgery Inc

Doing business as MO Foot and Ankle

  • Foot & Ankle Surgery Podiatrist
  • Saint Louis, MO
National Provider Identifier
1174595409
Registry record updated Sep 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
000765 Issued in MO
Legal business name
CENTER FOR ADVANCED FOOT & ANKLE SURGERY INC
Doing business as
MO Foot and Ankle
Practice address
621 S New Ballas Rd
Suite 7005B
Saint Louis, MO 63141-8232
Phone
(314) 991-3668
Fax
(314) 991-3665
NPI assigned
Feb 2, 2006
Last updated
Sep 30, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2019

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

Authorized official

Name
John Holtzman, DPMNPI 1851361133
Title
Delegated Official
Phone
(314) 991-3668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 000821 MO
Foot & Ankle Surgery Podiatrist 213ES0103X 2000157310 MO
Foot & Ankle Surgery Podiatrist 213ES0103X 000765 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd
Suite 7005B
Saint Louis, MO 63141-8232

Mailing address

PO Box 14000
Belfast, ME 04915-4033
Phone (314) 991-3668

Other names 1

  • MO Foot and Ankle Doing business as

National Provider Directory

National Provider Directory

Locations

1515 Astra Way
Arnold, MO 63010
Phone (636) 296-4051

500 W Pine St
Farmington, MO 63640
Phone (573) 701-9249

3915 Watson Rd
Ste 200
Saint Louis, MO 63109
Phone (314) 352-2711

621 S New Ballas Rd
Ste 7005B
Saint Louis, MO 63141
Phone (314) 207-4064

8067 Mexico Rd
Saint Peters, MO 63376
Phone (636) 379-2272

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1569801600000",
    "number": "1174595409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14000",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154033",
            "telephone_number": "314-991-3668",
            "fax_number": "314-991-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD",
            "address_2": "SUITE 7005B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418232",
            "telephone_number": "314-991-3668",
            "fax_number": "314-991-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR ADVANCED FOOT & ANKLE SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-02",
        "last_updated": "2019-09-30",
        "status": "A",
        "authorized_official_last_name": "HOLTZMAN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "314-991-3668",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "000821",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2000157310",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "000765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MO Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MO Foot and Ankle",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2019; 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.