NPIMap

Organization Active NPI

Ksu Foot & Ankle Clinic

Doing business as Cleveland Foot & Ankle Clinic

  • Podiatrist
  • Independence, OH
National Provider Identifier
1265793111
Registry record updated Oct 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
KSU FOOT & ANKLE CLINIC
Doing business as
Cleveland Foot & Ankle Clinic
Practice address
6000 Rockside Woods Blvd N
Independence, OH 44131-2330
Phone
(216) 916-7369
Fax
(216) 916-7369
NPI assigned
Jun 6, 2012
Last updated
Oct 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2012

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

Authorized official

Name
Charles Greene
Title
Director
Phone
(330) 672-2982

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X Primary

Addresses

Primary practice location

6000 Rockside Woods Blvd N
Independence, OH 44131-2330

Mailing address

6000 Rockside Woods Blvd. N.
Independence, OH 44131-2330
Phone (216) 916-5718

Other names 1

  • Cleveland Foot & Ankle Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120820001102 OH Part B Supplier - Clinic/Group Practice 1254588684 Receives reassigned benefits from 14 practitioners
Practice locations: Cleveland, OH; Independence, OH
O20120928000382 OH DME Supplier - Physician - Podiatry 1254588684 Practice locations: Independence, OH

National Provider Directory

National Provider Directory

Locations

700 Euclid Ave
Ste 101
Cleveland, OH 44114
Phone (216) 231-5612

7000 Euclid Ave
Ste 100
Cleveland, OH 44103

7000 Euclid Ave
Ste 101
Cleveland, OH 44103
Phone (216) 231-5612

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349827200000",
    "number": "1265793111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 ROCKSIDE WOODS BLVD. N.",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312330",
            "telephone_number": "216-916-5718",
            "fax_number": "216-916-7369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 ROCKSIDE WOODS BLVD N",
            "city": "INDEPENDENCE",
            "state": "OH",
            "postal_code": "441312330",
            "telephone_number": "216-916-7369",
            "fax_number": "216-916-7369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KSU FOOT & ANKLE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-10-10",
        "status": "A",
        "authorized_official_last_name": "GREENE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "330-672-2982"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cleveland Foot & Ankle Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Independence, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; 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.