NPIMap

Organization Active NPI

Blackmun Footcare LLC

  • Foot & Ankle Surgery Podiatrist
  • Saint Louis, MO
National Provider Identifier
1255620340
Registry record updated Apr 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
2010035799 Issued in MO
Legal business name
BLACKMUN FOOTCARE LLC
Practice address
2608 N 14TH St
Saint Louis, MO 63106-3913
Phone
(314) 932-1570
NPI assigned
Mar 29, 2011
Last updated
Apr 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2016

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

Authorized official

Name
Dr. Annessa Renee' Blackmun, DPMNPI 1538321047
Title
Owner
Phone
(502) 418-4809

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 2010035799 MO Primary

Addresses

Primary practice location

2608 N 14TH St
Saint Louis, MO 63106-3913

Mailing address

PO Box 23359
Saint Louis, MO 63156-3359
Phone (314) 932-1570

National Provider Directory

National Provider Directory

Locations

2608 N 14th St
Saint Louis, MO 63106
Phone (314) 932-1570

Practitioners & affiliated clinicians

Practitioners 1

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": "1301356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459814400000",
    "number": "1255620340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23359",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631563359",
            "telephone_number": "314-932-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 N 14TH ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631063913",
            "telephone_number": "314-932-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKMUN FOOTCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-29",
        "last_updated": "2016-04-05",
        "status": "A",
        "authorized_official_last_name": "BLACKMUN",
        "authorized_official_first_name": "ANNESSA",
        "authorized_official_middle_name": "RENEE'",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-418-4809",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MO",
            "license": "2010035799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.