Organization Active NPI

Foot and Ankle Specialists of Colorado PLLC

  • Podiatrist
  • Canon City, CO
National Provider Identifier
1215321856
Registry record updated Oct 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
POD.0000747 Issued in CO
Legal business name
FOOT AND ANKLE SPECIALISTS OF COLORADO PLLC
Practice address
604 S 9TH St
Canon City, CO 81212-4910
Phone
(719) 275-1037
NPI assigned
Mar 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2019

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

Authorized official

Name
Morgan KizzarNPI 1912261074
Title
Owner
Phone
(719) 275-1037

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X POD.0000747 CO Primary

Addresses

Primary practice location

604 S 9TH St
Canon City, CO 81212-4910

Mailing address

PO Box 576
Canon City, CO 81215-0576
Phone (719) 275-1037

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150522001965 CO Part B Supplier - Clinic/Group Practice 2961722426 Receives reassigned benefits from 1 practitioner
Practice locations: Canon City, CO
O20170126000894 CO DME Supplier - Physician - General Practice 2961722426 Practice locations: Canon City, CO

National Provider Directory

National Provider Directory

Locations

604 S 9th St
Canon City, CO 81212
Phone (719) 275-1037

1336 Bauer Ln
#B
Canon City, CO 81212
Phone (719) 275-1037

1336 Bauer Ln
Ste B
Canon City, CO 81212
Phone (719) 275-1037

515 Fairview Ave
Canon City, CO 81212
Phone (719) 269-1727

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1426809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571788800000",
    "number": "1215321856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 576",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812150576",
            "telephone_number": "719-275-1037",
            "fax_number": "719-275-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S 9TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124910",
            "telephone_number": "719-275-1037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOT AND ANKLE SPECIALISTS OF COLORADO PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-20",
        "last_updated": "2019-10-23",
        "status": "A",
        "authorized_official_last_name": "KIZZAR",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-275-1037"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "CO",
            "license": "POD.0000747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.