NPIMap

Organization Active NPI

Midwest Foot and Ankle Clinic LLC

  • Podiatrist
  • Archbold, OH
National Provider Identifier
1265014286
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
MIDWEST FOOT AND ANKLE CLINIC LLC
Practice address
121 Westfield Dr
Archbold, OH 43502-1056
Phone
(416) 799-1180
NPI assigned
Apr 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Authorized official

Name
Nitie I SroaNPI 1215236864
Title
DPM
Phone
(419) 518-7518

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 Primary

Addresses

Primary practice location

121 Westfield Dr
Archbold, OH 43502-1056

Mailing address

121 Westfield Dr
Archbold, OH 43502-1056
Phone (419) 518-7518

Other practice location 1

100 N Main St
Hicksville, OH 43526-1119
Phone (419) 518-7518

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210721000874 OH Part B Supplier - Clinic/Group Practice 6709289275 Receives reassigned benefits from 1 practitioner
Practice locations: Archbold, OH; Hicksville, OH

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Midwest Foot and Ankle Clinic LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

208 Columbus St
Ste 200
Hicksville, OH 43526
Phone (419) 799-1180

1035 W Wayne St
Ste 100
Paulding, OH 45879

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": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778198400000",
    "number": "1265014286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 WESTFIELD DR",
            "city": "ARCHBOLD",
            "state": "OH",
            "postal_code": "435021056",
            "telephone_number": "419-518-7518",
            "fax_number": "888-815-1037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 WESTFIELD DR",
            "city": "ARCHBOLD",
            "state": "OH",
            "postal_code": "435021056",
            "telephone_number": "416-799-1180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Main St",
            "address_purpose": "LOCATION",
            "city": "Hicksville",
            "state": "OH",
            "postal_code": "435261119",
            "country_code": "US",
            "telephone_number": "419-518-7518",
            "fax_number": "888-815-1037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIDWEST FOOT AND ANKLE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A",
        "authorized_official_last_name": "SROA",
        "authorized_official_first_name": "NITIE",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "419-518-7518"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Archbold, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2026; 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.