NPIMap

Organization Active NPI

Missouri Podiatric Surgicare LLC

  • Ambulatory Surgical Clinic/Center
  • Washington, MO
National Provider Identifier
1184804197
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
000689 Issued in MO
Legal business name
MISSOURI PODIATRIC SURGICARE LLC
Practice address
851 E 5TH St
Suite 228
Washington, MO 63090-3135
Phone
(636) 239-0018
Fax
(636) 239-0081
NPI assigned
Nov 7, 2007
Last updated
Nov 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Authorized official

Name
John M Dailey, DPM, MBA
Title
President
Phone
(636) 239-0018

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 000689 MO Primary

Addresses

Primary practice location

851 E 5TH St
Suite 228
Washington, MO 63090-3135

Mailing address

851 E 5TH St
Suite 228
Washington, MO 63090-3135
Phone (636) 239-0018

National Provider Directory

National Provider Directory
Tax ID family
Missouri Podiatric Surgicare LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1184804197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 E 5TH ST",
            "address_2": "SUITE 228",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903135",
            "telephone_number": "636-239-0018",
            "fax_number": "636-239-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 E 5TH ST",
            "address_2": "SUITE 228",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630903135",
            "telephone_number": "636-239-0018",
            "fax_number": "636-239-0081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI PODIATRIC SURGICARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "DAILEY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-239-0018",
        "authorized_official_credential": "DPM, MBA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": "000689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.