Golden Age Footcare

Primary specialty

Primary Podiatric Medicine PodiatristTaxonomy code 213EP1101X

Legal business name

GOLDEN AGE FOOTCARE

Practice address

323 S. 169 Highway
Gower, MO 64454-9116

Phone

(816) 304-8452

Fax

(816) 468-0742

NPI assigned

May 27, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Boremy Ly, DPMNPI 1336245125

Title

President

Phone

(816) 304-8452

Specialties & licenses 1

Addresses

Tax ID family

Golden Age Footcare2 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.

• Golden Age Footcare

  • Primary Podiatric Medicine Podiatrist
  • Olathe, KS
  • NPI 1427283191
  NPD tax ID

Practitioners 1

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

• Boremy Ly, DPM

  • Primary Podiatric Medicine Podiatrist
  • Kansas City, MO
  • NPI 1336245125

  Primary Podiatric Medicine

  NPD (past) Authorized official

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243382400000",
    "number": "1265667802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7818 N HULL AVE",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641511532",
            "telephone_number": "816-304-8452",
            "fax_number": "816-468-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S. 169 HIGHWAY",
            "city": "GOWER",
            "state": "MO",
            "postal_code": "644549116",
            "telephone_number": "816-304-8452",
            "fax_number": "816-468-0742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN AGE FOOTCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-27",
        "last_updated": "2009-05-27",
        "status": "A",
        "authorized_official_last_name": "LY",
        "authorized_official_first_name": "BOREMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "816-304-8452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213EP1101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joellen Aviles
• Steven D. Brushwood, DO
• East Buchanan C-I School District
• Abigail Elyse Filley, PTA
• Gower Convalescent Center Inc
• Gower Dental Care, LLC
• Gower Family Care Center PC
• Northwest Health Services, Inc
• Northwest Health Services, Inc.

• All providers in Gower, MO
• Primary Podiatric Medicine Podiatrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2009; 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.