NPIMap

Organization Active NPI

Academy Heights Foot Clinic PC

  • Foot & Ankle Surgery Podiatrist
  • Colorado Springs, CO
National Provider Identifier
1265593594
Registry record updated Feb 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
656 Issued in CO
Legal business name
ACADEMY HEIGHTS FOOT CLINIC PC
Practice address
1155 Kelly Johnson Blvd Ste 310
Colorado Springs, CO 80920
Phone
(719) 574-9800
Fax
(719) 574-9749
NPI assigned
Dec 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2020

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

Authorized official

Name
Dr. Lee T Fleming, DPMNPI 1124060488
Title
Owner
Phone
(719) 574-9800

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 366 CO
Foot & Ankle Surgery PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213ES0103X 656 CO Primary

Addresses

Primary practice location

1155 Kelly Johnson Blvd Ste 310
Colorado Springs, CO 80920

Mailing address

1155 Kelly Johnson Blvd Ste 310
Colorado Springs, CO 80920-3959
Phone (719) 574-9800

Other practice location 1

1512 N Union Blvd
Colorado Springs, CO 80909-2884
Phone (719) 632-7878

Other identifiers 1

IdentifierTypeStateIssuer
89502086MedicaidCO

Other names 1

  • COLORADO SPRINGS FOOT & ANKLE CLINIC Doing business as

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20061004000579 CO Part B Supplier - Clinic/Group Practice 8426054057 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: Colorado Springs, CO
O20100930024084 CO DME Supplier - Physician - PodiatryDME Supplier - Orthotic Personnel 8426054057 Practice locations: Colorado Springs, CO

Other NPIs with the same Medicare PAC ID 1

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

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Colorado Springs Foot and Ankle Cli1155 Kelly Johnson Blvd, Colorado Springs, CO 80920-3959(719) 574-9800 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Accepts assignmentParticipating since Sep 18, 2006

National Provider Directory

National Provider Directory
Tax ID family
Academy Heights Foot Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1512 N Union Blvd
Colorado Springs, CO 80909
Phone (719) 574-9800

3100 N Academy Blvd
Ste 115
Colorado Springs, CO 80917
Phone (719) 313-9317

1155 Kelly Johnson Blvd
Ste 310
Colorado Springs, CO 80920
Phone (719) 574-9800

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

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": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1265593594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1155 KELLY JOHNSON BLVD STE 310",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809203959",
            "telephone_number": "719-574-9800",
            "fax_number": "719-574-9749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1155 KELLY JOHNSON BLVD STE 310",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80920",
            "telephone_number": "719-574-9800",
            "fax_number": "719-574-9749"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1512 N Union Blvd",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809092884",
            "country_code": "US",
            "telephone_number": "719-632-7878",
            "fax_number": "719-574-9749",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ACADEMY HEIGHTS FOOT CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "FLEMING",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-574-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "366",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CO",
            "license": "656",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89502086",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLORADO SPRINGS FOOT & ANKLE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COLORADO SPRINGS FOOT & ANKLE CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.