NPIMap

Organization Active NPI

Premier Foot & Ankle Surgeons of Iowa PLLC

  • Podiatrist
  • Grimes, IA
National Provider Identifier
1205483765
Registry record updated Feb 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
PREMIER FOOT & ANKLE SURGEONS OF IOWA PLLC
Doing business as
Premier Foot & Ankle Surgeons of Iowa
Practice address
255 SW Brookside Dr
Ste 200
Grimes, IA 50111-5244
Phone
(515) 500-6568
Fax
(515) 393-6171
NPI assigned
Aug 20, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2021

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

Authorized official

Name
Dr. Drew Davidson, DPM
Title
Owner / Sole Managing Member
Phone
(515) 500-6568

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary
Podiatric Clinic/Center 261QP1100X

Addresses

Primary practice location

255 SW Brookside Dr
Ste 200
Grimes, IA 50111-5244

Mailing address

255 SW Brookside Dr
Ste 200
Grimes, IA 50111-5244
Phone (515) 500-6568

Other identifiers 1

IdentifierTypeStateIssuer
0125134MedicaidIA

Other names 1

  • Premier Foot & Ankle Surgeons of Iowa Doing business as

National Provider Directory

National Provider Directory

Locations

255 SW Brookside Dr
Ste 2
Grimes, IA 50111
Phone (515) 500-6568

NPI Registry JSON

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

{
    "created_epoch": "1566259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614211200000",
    "number": "1205483765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 SW BROOKSIDE DR",
            "address_2": "STE 200",
            "city": "GRIMES",
            "state": "IA",
            "postal_code": "501115244",
            "telephone_number": "515-500-6568",
            "fax_number": "515-393-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 SW BROOKSIDE DR",
            "address_2": "STE 200",
            "city": "GRIMES",
            "state": "IA",
            "postal_code": "501115244",
            "telephone_number": "515-500-6568",
            "fax_number": "515-393-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER FOOT & ANKLE SURGEONS OF IOWA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-20",
        "last_updated": "2021-02-25",
        "certification_date": "2021-02-25",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "DREW",
        "authorized_official_title_or_position": "OWNER / SOLE MANAGING MEMBER",
        "authorized_official_telephone_number": "515-500-6568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0125134",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Premier Foot & Ankle Surgeons of Iowa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grimes, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2021; 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.