Organization Active NPI

Mid-West Podiatry & Associates LLC

  • Foot & Ankle Surgery Podiatrist
  • Kirkwood, MO
National Provider Identifier
1205991015
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
Legal business name
MID-WEST PODIATRY & ASSOCIATES LLC
Practice address
141 E Madison Ave
Suite 100
Kirkwood, MO 63122-4330
Phone
(314) 821-8855
Fax
(314) 965-1296
NPI assigned
Dec 22, 2006
Last updated
Jun 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Authorized official

Name
Sandy Pike
Title
Biller
Phone
(314) 432-1903

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X NU Primary

Addresses

Primary practice location

141 E Madison Ave
Suite 100
Kirkwood, MO 63122-4330

Mailing address

141 E Madison Ave
Suite 100
Kirkwood, MO 63122-4330
Phone (314) 821-8855

Other identifiers 2

IdentifierTypeStateIssuer
365905405MedicaidMO
365905413MedicaidMO

National Provider Directory

National Provider Directory

Locations

1101 Weber Rd
Ste 301
Farmington, MO 63640
Phone (314) 432-1903

1055 Bowles Ave
Ste 100
Fenton, MO 63026
Phone (636) 203-9700

120 W Adams Ave
Saint Louis, MO 63122
Phone (314) 965-7070

205 Elm St
Washington, MO 63090
Phone (573) 239-7566

5129 Old Highway 100
Washington, MO 63090
Phone (636) 239-2331

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464825600000",
    "number": "1205991015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 E MADISON AVE",
            "address_2": "SUITE 100",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631224330",
            "telephone_number": "314-821-8855",
            "fax_number": "314-965-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E MADISON AVE",
            "address_2": "SUITE 100",
            "city": "KIRKWOOD",
            "state": "MO",
            "postal_code": "631224330",
            "telephone_number": "314-821-8855",
            "fax_number": "314-965-1296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-WEST PODIATRY & ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2016-06-02",
        "status": "A",
        "authorized_official_last_name": "PIKE",
        "authorized_official_first_name": "SANDY",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "314-432-1903"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "365905405",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "365905413",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkwood, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; 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.