NPIMap

Organization Active NPI

Center for Advanced Foot & Ankle Surgery Inc

  • 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
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
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, DPM
Title
Delegated Official
Phone
(314) 991-3668

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 000765 MO Primary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 000821 MO
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 2000157310 MO

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

1181 S State Route 157
#201B
Edwardsville, IL 62025

3445 Bridgeland Dr
Bridgeton, MO 63044
Phone (314) 739-7100

141 E Madison Ave
Ste 100
Kirkwood, MO 63122
Phone (314) 821-8855

3701 N Saint Peters Pkwy
Ste C1
Saint Peters, MO 63376
Phone (636) 720-0190

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

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

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": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "000765",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "000821",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2000157310",
            "primary": false
        }
    ],
    "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.