Bridgeton Foot and Ankle LLC

Primary specialty

PodiatristTaxonomy code 213E00000X

License

000551 Issued in MO

Legal business name

BRIDGETON FOOT AND ANKLE LLC

Practice address

12255 De Paul Dr
Ste. 470
Bridgeton, MO 63044-2510

Phone

(314) 739-8863

Fax

(314) 739-6448

NPI assigned

Feb 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Anthony M Lombardo, D.P.M.

Title

Physician

Phone

(314) 739-8863

Specialties & licenses 1

Addresses

Other identifiers 9

Locations

Practitioners 1

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

• Timothy James Oldani, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Saint Louis, MO
  • NPI 1225143480
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259798400000",
    "number": "1205975968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12255 DE PAUL DR",
            "address_2": "STE. 470",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442510",
            "telephone_number": "314-739-8863",
            "fax_number": "314-739-6448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 DE PAUL DR",
            "address_2": "STE. 470",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442510",
            "telephone_number": "314-739-8863",
            "fax_number": "314-739-6448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGETON FOOT AND ANKLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2009-12-03",
        "status": "A",
        "authorized_official_last_name": "LOMBARDO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "314-739-8863",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MO",
            "license": "000551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2700030",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARD",
            "identifier": "480034196",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "32B00000X",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2784098",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00419552",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303231500",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300628401",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CPIN",
            "identifier": "310171750",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP",
            "identifier": "504595802",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donna Marie Branca, ACSW, MSW, BCD, LCSW
• Kayla Braswell
• Brianna Raynae Bray, PHARMD
• Christine E Breakfield, RDN, LD
• Bridgeton Emergency Group LLC
• Bridgeton Geriatrics LLC
• Bridgeton Imaging, L.L.C.
• Bridgeton Operations, LLC
• Bridgeton Pain Group
• Brielle Holly Bright, PT, DPT

• Podiatrist in Bridgeton, MO
• Providers in Bridgeton, MO by specialty
• Podiatrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2009; 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.