NPIMap

Organization Active NPI

Advanced Ankle and Foot Surgeons, LLC

  • Podiatrist
  • O'Fallon, IL
National Provider Identifier
1275773293
Registry record updated Apr 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
016.004852 Issued in IL
Legal business name
ADVANCED ANKLE AND FOOT SURGEONS, LLC
Practice address
4905 Stone Falls Ctr Ste B
O Fallon, IL 62269-7802
Phone
(618) 277-0001
Fax
(618) 277-7339
NPI assigned
Mar 3, 2009
Last updated
Apr 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2025

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

Authorized official

Name
Michele Taylor, JD
Title
Cfo
Phone
(618) 277-0001

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 016.004852 IL Primary

Addresses

Primary practice location

4905 Stone Falls Ctr Ste B
O Fallon, IL 62269-7802

Mailing address

4905 Stone Falls Ctr Ste B
O Fallon, IL 62269-7802
Phone (618) 277-0001

Other practice location 1

311 E Hanover St
New Baden, IL 62265-1813
Phone (618) 277-0001

Other names 1

  • Affiliated Ankle and Foot Surgeons Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090430000454 IL Part B Supplier - Clinic/Group Practice 2769530740 Receives reassigned benefits from 6 practitioners
Practice locations: New Baden, IL; O'Fallon, IL
O20100930022827 IL DME Supplier - Physician - Podiatry 2769530740 Practice locations: O Fallon, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1236038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745193600000",
    "number": "1275773293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4905 STONE FALLS CTR STE B",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622697802",
            "telephone_number": "618-277-0001",
            "fax_number": "618-277-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4905 STONE FALLS CTR STE B",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622697802",
            "telephone_number": "618-277-0001",
            "fax_number": "618-277-7339"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 E Hanover St",
            "address_purpose": "LOCATION",
            "city": "New Baden",
            "state": "IL",
            "postal_code": "622651813",
            "country_code": "US",
            "telephone_number": "618-277-0001",
            "fax_number": "618-277-7339",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVANCED ANKLE AND FOOT SURGEONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-03",
        "last_updated": "2025-04-21",
        "certification_date": "2025-04-21",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "618-277-0001",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "IL",
            "license": "016.004852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affiliated Ankle and Foot Surgeons",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Affiliated Ankle and Foot Surgeons",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in O'Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2025; 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.